2014 Survey of Income and Program Participation (SIPP) Panel

Forms and Documents

Document Name	Status
Form Items Booklet 2014 Survey of Income and Program Participation Panel Form	New
2014 PANEL SIPP OMB83-I (2017 extension) (signed 8-22-16).pdf Supplementary Document	2016-08-23
Attachment R - 60 Day Notice 2014 SIPP - 2017 Renewal.docx Supplementary Document	2016-08-22
Attachment Q - 2015 FCSM - Incentives.pdf Supplementary Document	2016-08-22
Attachment P - sipp106(L1)2015 Thank You Letter (Incentive).pdf Supplementary Document	2016-08-22
Attachment O - sipp106(L1)2015 Thank You Letter.pdf Supplementary Document	2016-08-22
Attachment N - SIPP-PIN-2016.pdf Supplementary Document	2016-08-22
Attachment M - CARI Evaluation.pdf Supplementary Document	2016-08-22
Attachment L - 2015 FCSM - CARI.pdf Supplementary Document	2016-08-22
Attachment K - EHC_Evaluation_report_July2013_Final.pdf Supplementary Document	2016-08-22
Attachment J - SIPP-INF1_2014.pdf Supplementary Document	2016-08-22
Attachment I - SIPP News Postcard.pdf Supplementary Document	2016-08-22
Attachment H - Labor Force_Brochure.pdf Supplementary Document	2016-08-22
Attachment G - Families with Children Brochure.pdf Supplementary Document	2016-08-22
Attachment F - Health Insurance Brochure.pdf Supplementary Document	2016-08-22
Attachment E - SIPP 101_Factsheet.pdf Supplementary Document	2016-08-22
Attachment D - SIPP Respondent Rules.pdf Supplementary Document	2016-08-22
Attachment C - 2016 SIPP Advance Letter (Incentive).pdf Supplementary Document	2016-08-22
Attachment B - 2016 SIPP Advance Letter.pdf Supplementary Document	2016-08-22
Attachment A - 2016 SIPP Items Booklet.pdf Supplementary Document	2016-08-22
2014 SIPP Panel - 2017 Renewal Section B (Final Draft).docx Supporting Statement B	2016-08-22
2014 SIPP Panel - 2017 Renewal Section A (Final Draft).docx Supporting Statement A	2016-08-22

IC Document Collections

IC ID	Document Title	Status
223138	2014 Survey of Income and Program Participation Panel Form	New
208349	SIPP 2014 Panel Other-SIPP Brochure: Labor Force and Employment	Unchanged

ICR Details

OMB Control No: 0607-0977	ICR Reference No: 201608-0607-003
Status: Historical Active	Previous ICR Reference No: 201308-0607-001
Agency/Subagency: DOC/CENSUS	Agency Tracking No:
Title: 2014 Survey of Income and Program Participation (SIPP) Panel
Type of Information Collection: Extension without change of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 11/15/2016
	Date Received in OIRA: 09/13/2016
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	11/30/2019	36 Months From Approved	12/31/2016
Responses	137,550	0	73,500
Time Burden (Hours)	116,200	0	73,500
Cost Burden (Dollars)	0	0	0

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Abstract: This survey will provide improved statistics for the executive and legislative branches on income distribution and data not previously available on eligibility for and participation in government programs. Changes in status and participation will be measured over time. These data will support policy and program planning. All people 15 years old or older in sample households are interviewed.

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Authorizing Statute(s): US Code: 13 USC 141 Name of Law: null
   US Code: 13 USC 182 Name of Law: null
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	81 FR 17137	03/28/2016
30-day Notice:	Federal Register Citation:	Citation Date:
	81 FR 59981	08/31/2016
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 2

IC Title	Form No.	Form Name
2014 Survey of Income and Program Participation Panel	Items Booklet	Items Booklet
SIPP 2014 Panel	EHC, Items Booklet	Items Booklet ,   EHC

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ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	137,550	73,500	0	64,050	0	0
Annual Time Burden (Hours)	116,200	73,500	0	42,700	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: Change (decrease) due to change in estimated workload and shorter actual interview times compared to expected interview times.

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Annual Cost to Federal Government: $35,000,000

Does this IC contain surveys, censuses, or employ statistical methods? Yes Part B of Supporting Statement

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 09/13/2016

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