Information Collection

Group Quarters

IC 227088 under ICR 201706-0607-001 · OMB 0607-0999.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0607-0999 can be found here:

2018-11-30 - No material or nonsubstantive change to a currently approved collection
2018-03-08 - No material or nonsubstantive change to a currently approved collection

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
dh_5_gq_20170509.pdf	Other-Envelope
dh_5_eresponse_20170515.pdf	Other-Envelope-eResponse
dh_40_20170512.pdf	Other-Envelope
dh_40_gq_20170512.pdf	Other-Envelope
dh_40_s_20170512.pdf	Other-Envelope- Spanish
GQE Brochure 2018 _20170511.pdf	Other-Brochure- Group Quarters Enume
SBE Brochure20170517.pdf	Other-Brochure-Service-Based Enumera
dh_31_gq_es_20170515.pdf	Other-Confidentiality Notice
DH-941(GQE).pdf	Other-GQ Reinterview Form
dh_18_gq_20170515.pdf	Other-GQ Facility Manager Letter
dh_30_l_fm_es_20170516.pdf	Other-GQ Facility Manager Letter - E
dh_30_l_hc_es_20170516.pdf	Other-GQ Facility Manager Letter- En
dh_30_l_sh_es_20170516.pdf	Other-GQ Facility Manager Letter- En
DH_1028_4 20170310.pdf	Other-Living Quarters Flashcard- Eng
DH_1028_4S_ 20170310.pdf	Other-Living Quarters Flashcard- Spa
DH-352.1 (GQE) All Enumeration Records (See bottom Tabs for type) 5_16_17.DD_DRAFT.xls	Other-Enumeration Records
Advance Contact Calling Script_ NON-SBE GQ_05162017_DRAFT.docx	Other-GQ Advance Contact Call Script
Advance Contact Calling Script_EMERGENCY AND TRANSITIONAL CENTERS_05162017_DRAFT.docx	Other-GQ Advance Contact Call Script
Advance Contact Calling Script_MOBILE FOOD VAN_05162017_DRAFT.docx	Other-GQ Advance Contact Call Script
Advance Contact Calling Script_SOUP KITCHEN_05162017_DRAFT.docx	Other-GQ Advance Contact Call Script
eResponseTemplate_2018_DRAFT.xlsx	Other-eResponse Template
eResponse Video Script_DRAFT.docx	Instruction
DH-116 draft.xlsx	Other-Group Quarters Listing Sheet
DH-1054(GQE) draft.xlsx	Other-Group Quarters Enumerator Chec
DH-1054(SBE) draft.xlsx	Other-Group Quarters Enumerator Chec
DH-1055(GQE) draft.xlsx	Other-Group Quarters Enumeration-Cen
DH-1059(SE) draft.xlsx	Other-Self-Enumerating Group Quarter
dh_18_eresponse_20170608.pdf	Other-GQ Facility Manager Letter- eR
DH-20 Individual Census Questionnaire- English DH-20_051717.pdf	Form
DH-20(S) Individual Census Questionnaire- Spanish DH-20(S)_051717.pdf	Form
DH-61(ICQ) Individual Census Questionnaire-Informational Copy DH-61(ICQ)_050317.pdf	Form
DH-61(ICQ)S Individual Census Questionnaire-Informational Copy- Span DH-61(ICQ)S_050317.pdf	Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:

Group Quarters

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Mandatory

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
Other-Group Quarters Listing Sheet			DH-116 draft.xlsx	No		Paper Only
Other-Group Quarters Enumerator Checklist			DH-1054(GQE) draft.xlsx	No		Paper Only
Other-Group Quarters Enumerator Checklist-Service Based Enumeration			DH-1054(SBE) draft.xlsx	No		Paper Only
Other-Group Quarters Enumeration-Census Field Supervisor Checklist			DH-1055(GQE) draft.xlsx	No		Paper Only
Form	DH-20	Individual Census Questionnaire- English	DH-20_051717.pdf	No		Paper Only
Form	DH-20(S)	Individual Census Questionnaire- Spanish	DH-20(S)_051717.pdf	No		Paper Only
Form	DH-61(ICQ)	Individual Census Questionnaire-Informational Copy	DH-61(ICQ)_050317.pdf	No		Paper Only
Form	DH-61(ICQ)S	Individual Census Questionnaire-Informational Copy- Spanish	DH-61(ICQ)S_050317.pdf	No		Paper Only
Other-Envelope			dh_5_gq_20170509.pdf	No		Paper Only
Other-Envelope-eResponse			dh_5_eresponse_20170515.pdf	No		Paper Only
Other-Envelope			dh_40_20170512.pdf	No		Paper Only
Other-Envelope			dh_40_gq_20170512.pdf	No		Paper Only
Other-Envelope- Spanish			dh_40_s_20170512.pdf	No		Paper Only
Other-Brochure- Group Quarters Enumeration			GQE Brochure 2018 _20170511.pdf	No		Paper Only
Other-Brochure-Service-Based Enumeration			SBE Brochure20170517.pdf	No		Paper Only
Other-Confidentiality Notice			dh_31_gq_es_20170515.pdf	No		Paper Only
Other-GQ Reinterview Form			DH-941(GQE).pdf	No		Paper Only
Other-GQ Facility Manager Letter			dh_18_gq_20170515.pdf	No		Paper Only
Other-GQ Facility Manager Letter - English/Spanish			dh_30_l_fm_es_20170516.pdf	No		Paper Only
Other-GQ Facility Manager Letter- Engish/Spanish			dh_30_l_hc_es_20170516.pdf	No		Paper Only
Other-GQ Facility Manager Letter- English/Spanish			dh_30_l_sh_es_20170516.pdf	No		Paper Only
Other-Living Quarters Flashcard- English			DH_1028_4 20170310.pdf	No		Paper Only
Other-Living Quarters Flashcard- Spanish			DH_1028_4S_ 20170310.pdf	No		Paper Only
Other-Enumeration Records			DH-352.1 (GQE) All Enumeration Records (See bottom Tabs for type) 5_16_17.DD_DRAFT.xls	No		Paper Only
Other-GQ Advance Contact Call Script- Non-SBE GQ			Advance Contact Calling Script_ NON-SBE GQ_05162017_DRAFT.docx	No		Paper Only
Other-GQ Advance Contact Call Script-Emergency and Transitional Centers			Advance Contact Calling Script_EMERGENCY AND TRANSITIONAL CENTERS_05162017_DRAFT.docx	No		Paper Only
Other-GQ Advance Contact Call Script- Mobile Food Vans			Advance Contact Calling Script_MOBILE FOOD VAN_05162017_DRAFT.docx	No		Paper Only
Other-GQ Advance Contact Call Script- Soup Kitchen			Advance Contact Calling Script_SOUP KITCHEN_05162017_DRAFT.docx	No		Paper Only
Other-eResponse Template			eResponseTemplate_2018_DRAFT.xlsx	Yes	Yes	Fillable Fileable
Instruction			eResponse Video Script_DRAFT.docx	No		Paper Only
Other-Self-Enumerating Group Quarters-Facility Contact Checklist			DH-1059(SE) draft.xlsx	No		Paper Only
Other-GQ Facility Manager Letter- eResponse			dh_18_eresponse_20170608.pdf	Yes	Yes	Fillable Fileable

Federal Enterprise Architecture Business Reference Module

Line of Business: General Government

Subfunction: Central Records & Statistical Mgt

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 30,690

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 25 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	30,690	30,690
Annual IC Time Burden (Hours)	5,115	5,115
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
No associated records found

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