Information Collection Request

2017 Census Test

ICR 201609-0607-002 · OMB 0607-0996 · Historical Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form DG-1D 2017 Census Test - Self Response Form New Available
2017 Census Test GOSC 3.1.pdf Supplementary Document Uploaded 2016-12-01 Available
2017 Census Test OMB Package Part A_final with updates.docx Supporting Statement A Uploaded 2017-01-19 Available
2017 Census Test _83I.pdf Supplementary Document Uploaded 2016-11-17 Available
Adjustment of FY2017 Test Scope Memo.pdf Supplementary Document Uploaded 2016-11-14 Available
2017 Census Test OMB Package Part B_final with updates.docx Supporting Statement B Uploaded 2017-01-19 Available

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
224067 2017 Census Test - Content Reinterview Other-Content Reinterview Phone Flowchart New
224066 2017 Census Test - Self Response Form New

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
03/31/2018 03/31/2018
43,500 0 0
6,875 0 0
0 0 0





Reginfo record details
2
table that charts list of burden
IC Title Form No. Form Name
2017 Census Test - Self Response DG-1D, DG-1D(E/S) English paper questionnaire ,   English/Spanish paper questionnaire
2017 Census Test - Content Reinterview

table that charts list 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 43,500 0 0 43,500 0 0
Annual Time Burden (Hours) 6,875 0 0 6,875 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No