Information Collection

ORS Incumbent Survey Development Test

IC 222647 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⚠️ Notice: This information collection may be referencing outdated material.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 A ORS Incumbent Survey Development Test	Form
Attachment A ORS Incumbent Test Stylized Questionnaire Attachment-A_ORS_Incumbent_Test_Stylized_Questionnaire_7-25-16.docx	Form and Instruction
Attachment B - Inc Diary Instructions Attachment-B_ORS Incumbent Diary Instructions_7-25-16.docx	Form and Instruction
Attachment C Incumbent Diary Form Attachment-C_ORS_Incumbent_Diary_Blank.xlsx	Form
Attachment D ORS Form Attachment-D_ORS_form2016.pdf	Form and Instruction
Appendix A Screening Questions Appendix A - Screening Questions.docx	Form
Appendix C -- Cons Consent Form Appendix C - Consent Form.docx	Form
Appendix D Debriefing Questions Appendix D - Debriefing Questions.docx	Form
Note to Reviewer - ORS_Incumbent_Survey.docx Note to Reviewer	IC Document

IC Title:

ORS Incumbent Survey Development Test

Agency IC Tracking Number:

21619

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	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	Appendix A	Screening Questions	Appendix A - Screening Questions.docx	Yes	No	Printable Only
Form	Appendix C -- Consent Form	Consent Form	Appendix C - Consent Form.docx	Yes	No	Printable Only
Form	Appendix D	Debriefing Questions	Appendix D - Debriefing Questions.docx	Yes	No	Printable Only
Form and Instruction	Attachment A	ORS Incumbent Test Stylized Questionnaire	Attachment-A_ORS_Incumbent_Test_Stylized_Questionnaire_7-25-16.docx	Yes	No	Printable Only
Form and Instruction	Attachment B - Incumbent Diary	Diary Instructions	Attachment-B_ORS Incumbent Diary Instructions_7-25-16.docx	Yes	No	Printable Only
Form	Attachment C	Incumbent Diary Form	Attachment-C_ORS_Incumbent_Diary_Blank.xlsx	Yes	No	Printable Only
Form and Instruction	Attachment D	ORS Form	Attachment-D_ORS_form2016.pdf	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: 43

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Requested	Previously Approved
Annual Number of Responses for this IC	73	73
Annual IC Time Burden (Hours)	37	37
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Note to Reviewer	Note to Reviewer - ORS_Incumbent_Survey.docx	07/27/2016

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