Information Collection

MEPS Cognitive Testing

IC 235377 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⚠️ Notice: This information collection may be referencing outdated material.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 1 MEPS Cognitive Testing	Form and Instructi
1 Form MEPS 10 meps10_021519.pdf	Form and Instruction
2 Form MEPS 10s meps10s_021519.pdf	Form and Instruction
3 Form MEPS 11 meps11_021519.pdf	Form and Instruction
4 Form MEPS 11s meps11s_021519.pdf	Form and Instruction
MEPS_IC_OMB_letter_31419.docx OMB Memo	IC Document
Attachment A_MEPS Interview_Protocol.docx Protocol	IC Document

IC Title:

MEPS 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	1	Form MEPS 10	meps10_021519.pdf	No	Fillable Fileable
Form and Instruction	2	Form MEPS 10s	meps10s_021519.pdf	No	Fillable Fileable
Form and Instruction	3	Form MEPS 11	meps11_021519.pdf	No	Fillable Fileable
Form and Instruction	4	Form MEPS 11s	meps11s_021519.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: 60

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	60	60
Annual IC Time Burden (Hours)	35	35
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
OMB Memo	MEPS_IC_OMB_letter_31419.docx	03/18/2019
Protocol	Attachment A_MEPS Interview_Protocol.docx	03/18/2019

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