Information Collection

American Community Survey (ACS) Survey Mail Materials Eye-tracking Study

IC 235086 under ICR 201705-0690-001 · OMB 0690-0030.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0690-0030 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Enclosure 1 ACS Eyetracking Protocol.docx	Instruction
Enclosure 2 Demographic questionnaire.docx	Other-Questionnaire
Enclosure 3 Survey invitation letters.pdf	Other-Invitation letters
Enclosure 4 Sample recall questionnaire.docx	Other-Questionnaire
Enclosure 5 Recruitment materials (2).docx	Other-Recruitment materials
Enclosure 6 Additional screening questions.docx	Other-Screening questions
Consent Form Enclosure 7 Consent form.docx	Form
OMB letter - ACS Mail Materials Eyetracking Study (2).docx OMB Letter	IC Document
Fast Track Memo - ACS Mail Materials Eyetracking Study.docx Fast Track Request	IC Document

IC Title:

American Community Survey (ACS) Survey Mail Materials Eye-tracking Study

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?	Can Be Submitted Electronically?	Electronic Capability
Instruction			Enclosure 1 ACS Eyetracking Protocol.docx	Yes	Yes	Fillable Fileable
Other-Questionnaire			Enclosure 2 Demographic questionnaire.docx	Yes	Yes	Fillable Fileable
Other-Invitation letters			Enclosure 3 Survey invitation letters.pdf	Yes	Yes	Fillable Fileable
Other-Questionnaire			Enclosure 4 Sample recall questionnaire.docx	Yes	Yes	Fillable Fileable
Other-Recruitment materials			Enclosure 5 Recruitment materials (2).docx	Yes	Yes	Fillable Fileable
Other-Screening questions			Enclosure 6 Additional screening questions.docx	Yes	Yes	Fillable Fileable
Form	NA	Consent Form	Enclosure 7 Consent form.docx	Yes	Yes	Fillable Fileable

Line of Business: General Government

Subfunction: Central Records & Statistical Mgt

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 20

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

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	20	20
Annual IC Time Burden (Hours)	28	28
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
OMB Letter	OMB letter - ACS Mail Materials Eyetracking Study (2).docx	02/25/2019
Fast Track Request	Fast Track Memo - ACS Mail Materials Eyetracking Study.docx	02/25/2019

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