Information Collection

2018 BRDIS Cognitive Testing

IC 230041 under ICR 201606-0607-003 · OMB 0607-0725.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0607-0725 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 2 2018 BRDIS Cognitive Testing	Form and Instructi
1 BRDIS 2016 Enclosure 2 - 2016 BRDIS Form.pdf	Form and Instruction
2 Geography Questions Enclosure 3 - Additional Geography Question Drafts.docx	Form and Instruction
3 Capitol Stock Questions Enclosure 4 - Additional Capital Stock Questions.docx	Form and Instruction
4 Consent Form Enclosure 5 - Consent Form.doc	Form and Instruction
OMB Request - 2018 BRDIS Cognitive Interviewing REVISED.docx OMB Memo	IC Document
Enclosure 1 - Protocol 2018 BRDIS Cognitive Testing.docx Protocol	IC Document

IC Title:

2018 BRDIS Cognitive Testing

Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Electronic Capability
Form and Instruction	2	Geography Questions	Enclosure 3 - Additional Geography Question Drafts.docx	No	Fillable Fileable
Form and Instruction	4	Consent Form	Enclosure 5 - Consent Form.doc	No	Fillable Fileable
Form and Instruction	1	BRDIS 2016	Enclosure 2 - 2016 BRDIS Form.pdf	No	Fillable Fileable
Form and Instruction	3	Capitol Stock Questions	Enclosure 4 - Additional Capital Stock Questions.docx	No	Fillable Fileable

Line of Business: General Government

Subfunction: Central Records & Statistical Mgt

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 40

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	40	40
Annual IC Time Burden (Hours)	50	50
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
OMB Memo	OMB Request - 2018 BRDIS Cognitive Interviewing REVISED.docx	03/15/2018
Protocol	Enclosure 1 - Protocol 2018 BRDIS Cognitive Testing.docx	02/12/2018

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.