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

Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery

⚠️ Notice: This information collection may be referencing outdated material.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

Documents and Forms

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

Information Collection (IC) Details

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:

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 %

	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

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.