ACS Respondent Comment/Feedback Addendum

Generic Clearance for Questionnaire Pretesting Research

⚠️ Notice: This information collection may be referencing outdated material.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

Documents and Forms

Document Name Document Type
Form 1 ACS Respondent Comment/Feedback Addendum Form and Instructi
1 Entire ACS Questionnaire Enclosure 4-ACS questionnaire.pdf Form and Instruction
2 ACS Respondent Feedback items at end of ACS Questionnair Enclosure 5-Respondent Feedback and Comment Questions.pdf Form and Instruction
ACS Respondent-Comment Feedback_Addendum (2).docx OMB Memo IC Document
Enclosure 1-Round 1 - Part 1.docx Round 1 Protocol Part 1 (respondent burden) IC Document
Enclosure 2- Round 1 Protocol - Part 2.docx Round 1 Protocol Part 2 (respondent feedback) IC Document
Enclosure 3A-Round 2 Protocol with Respondent Comment-Feedback Questions.docx Round 2 Protocol Version 1 IC Document
Enclosure 3B- Round 2 Protocol with Respondent Comment-Feedback and Ancestry Questions.docx Round 2 Protocol Version 2 IC Document
Enclosure 6 - Additional Screener Questions.docx Screener Questions IC Document
Enclosure 7 - Recruitment advertisement text (2).docx Recruitment Ads IC Document
Enclosure 8 - Consent form.docx Consent Form IC Document

Information Collection (IC) Details

IC Title:	ACS Respondent Comment/Feedback Addendum	Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	1	Entire ACS Questionnaire	Enclosure 4-ACS questionnaire.pdf		No		Fillable Fileable
Form and Instruction	2	ACS Respondent Feedback items at end of ACS Questionnaire	Enclosure 5-Respondent Feedback and Comment Questions.pdf		No		Fillable Fileable

Line of Business: General Government

Subfunction: Central Records & Statistical Mgt

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 15	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	15	15
Annual IC Time Burden (Hours)	7	7
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
OMB Memo	ACS Respondent-Comment Feedback_Addendum (2).docx	06/12/2018
Round 1 Protocol Part 1 (respondent burden)	Enclosure 1-Round 1 - Part 1.docx	06/12/2018
Round 1 Protocol Part 2 (respondent feedback)	Enclosure 2- Round 1 Protocol - Part 2.docx	06/12/2018
Round 2 Protocol Version 1	Enclosure 3A-Round 2 Protocol with Respondent Comment-Feedback Questions.docx	06/12/2018
Round 2 Protocol Version 2	Enclosure 3B- Round 2 Protocol with Respondent Comment-Feedback and Ancestry Questions.docx	06/12/2018
Screener Questions	Enclosure 6 - Additional Screener Questions.docx	06/12/2018
Recruitment Ads	Enclosure 7 - Recruitment advertisement text (2).docx	06/12/2018
Consent Form	Enclosure 8 - Consent form.docx	06/12/2018

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