Information Collection

QIPT Focus Groups

IC 232802 under ICR 201706-0607-003 · OMB 0607-0978.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0607-0978 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1 QIPT Focus Groups	Form and Instruction
1 Online Testing Questionnaire Appendix A - Online Testing Questionnaire.docx	Form and Instruction
2 Focus Group Activity Appendix E - Focus Group Activities.docx	Form and Instruction
2020 Census ICC QIPT OMB Memo_Revised.docx OMB Memo	IC Document
Appendix B - Focus Group Screening Questionnaire by Audience_Revised.docx Focus Group Screeners	IC Document
Appendix C - Focus Group Audience Criteria with Quota Tables_Revised.docx Focus Group Criteria	IC Document
Appendix D - Focus Group Discussion Guide.docx Focus Group Discussion Guide	IC Document
Appendix F - Focus Group Consent Form.docx Focus Group Consent Form	IC Document
Appendix G - Example Focus Group Advertising.docx Example Focus Group Advertising	IC Document

IC Title:

QIPT Focus Groups

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	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	1	Online Testing Questionnaire	Appendix A - Online Testing Questionnaire.docx		No		Fillable Fileable
Form and Instruction	2	Focus Group Activity	Appendix E - Focus Group Activities.docx		No		Fillable Fileable

Line of Business: General Government

Subfunction: Central Records & Statistical Mgt

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 1,944

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 93 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	1,944	1,944
Annual IC Time Burden (Hours)	1,418	1,418
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
OMB Memo	2020 Census ICC QIPT OMB Memo_Revised.docx	10/11/2018
Focus Group Screeners	Appendix B - Focus Group Screening Questionnaire by Audience_Revised.docx	10/11/2018
Focus Group Criteria	Appendix C - Focus Group Audience Criteria with Quota Tables_Revised.docx	10/11/2018
Focus Group Discussion Guide	Appendix D - Focus Group Discussion Guide.docx	08/23/2018
Focus Group Consent Form	Appendix F - Focus Group Consent Form.docx	08/23/2018
Example Focus Group Advertising	Appendix G - Example Focus Group Advertising.docx	10/11/2018

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