Information Collection

Pretesting changes for the 2017 CE Quarterly Survey

IC 219474 under ICR 201608-1220-001 · OMB 1220-0141.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1220-0141 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form Appendix B Pretesting changes for the 2017 CE Quarterly Survey	Form and Instruction
Appendix B Testing Protocol 1220-0141 Appendix B - Testing Protocol - FINAL 2.2016.docx	Form and Instruction
Appendix C Consent Form for Cognitive Testing 1220-0141 Appendix C FINAL 2.2016.docx	Form and Instruction
1220-0141 Note to Reviewer - OMB CEQ 2017 Changes FINAL (3Feb16).docx Gen IC Justification	IC Document

IC Title:

Pretesting changes for the 2017 CE Quarterly Survey

Agency IC Tracking Number:

21605

IC Status: Unchanged

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	Appendix B	Testing Protocol	1220-0141 Appendix B - Testing Protocol - FINAL 2.2016.docx		Yes	No	Printable Only
Form and Instruction	Appendix C	Consent Form for Cognitive Testing	1220-0141 Appendix C FINAL 2.2016.docx		Yes	No	Printable Only

Line of Business: General Government

Subfunction: Central Records & Statistical Mgt

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 740

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 95 %

table that charts list of burden
	Requested	Previously Approved
Annual Number of Responses for this IC	740	740
Annual IC Time Burden (Hours)	123	123
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Gen IC Justification	1220-0141 Note to Reviewer - OMB CEQ 2017 Changes FINAL (3Feb16).docx	02/03/2016

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