Information Collection

2019 ABS Innovation Module Cognitive Testing

IC 236008 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⚠️ Notice: This information collection may be referencing outdated material.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 Revised Innovation Module 2019 ABS Innovation Module Cognitive Testing	Form and Instruction
Form 2 Innovation Handout 2019 ABS Innovation Module Cognitive Testing	Form and Instruction
Form 3 Barriers and Drivers Handout 2019 ABS Innovation Module Cognitive Testing	Form and Instruction
Form 4 Business Strategies Handout 2019 ABS Innovation Module Cognitive Testing	Form and Instruction
Form 5 Digital Tech Cards 2019 ABS Innovation Module Cognitive Testing	Form and Instruction
Form 6 Tech Capabilities List 2019 ABS Innovation Module Cognitive Testing	Form and Instruction
1 Revised Innovation Module Attachment B - Revised Innovation Module.docx	Form and Instruction
2 Innovation Handout Attachment C - Innovation Handout 1.docx	Form and Instruction
3 Barriers and Drivers Handout Attachment D - Drivers and Barriers to Innovation Handout.docx	Form and Instruction
4 Business Strategies Handout Attachment E - Business Strategies Versions A & B.docx	Form and Instruction
5 Digital Tech Cards Attachment F - Digital Technologies Cards.docx	Form and Instruction
6 Tech Capabilities List Attachment G - Technology Capabilities Lists.docx	Form and Instruction
2019 ABS Innovation Module Cogtive Testing OMB Request.docx OMB Memo	IC Document
Attachment A - Innovation Module Protocol.docx Protocol	IC Document
Attachment H - Consent form with letterhead.doc Consent Form	IC Document
Attachment I - Cognitive Interview Recruiting Script.docx Recruitment Script	IC Document

IC Title:

2019 ABS Innovation Module 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	Revised Innovation Module	Attachment B - Revised Innovation Module.docx	No	Fillable Fileable
Form and Instruction	2	Innovation Handout	Attachment C - Innovation Handout 1.docx	No	Fillable Fileable
Form and Instruction	3	Barriers and Drivers Handout	Attachment D - Drivers and Barriers to Innovation Handout.docx	No	Fillable Fileable
Form and Instruction	4	Business Strategies Handout	Attachment E - Business Strategies Versions A & B.docx	No	Fillable Fileable
Form and Instruction	5	Digital Tech Cards	Attachment F - Digital Technologies Cards.docx	No	Paper Only
Form and Instruction	6	Tech Capabilities List	Attachment G - Technology Capabilities Lists.docx	No	Paper Only

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	2019 ABS Innovation Module Cogtive Testing OMB Request.docx	05/08/2019
Protocol	Attachment A - Innovation Module Protocol.docx	05/08/2019
Consent Form	Attachment H - Consent form with letterhead.doc	05/08/2019
Recruitment Script	Attachment I - Cognitive Interview Recruiting Script.docx	05/08/2019

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