Information Collection

Pretesting CE 2019 Interview and Diary Changes

IC 229696 under ICR 201706-1220-008 · OMB 1220-0141.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1220-0141 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form Appendix B and C Pretesting CE 2019 Interview and Diary Changes	Form and Instruction
Appendix B and C Interview Protocol and Consent Form Appendix B and C - Interview Protocol and Consent Form.docx	Form and Instruction
Note to Reviewer - OMB CEQ and CED 2019.docx Note to Reviewer - Pretesting 2019 CE Changes	IC Document

IC Title:

Pretesting CE 2019 Interview and Diary Changes

Agency IC Tracking Number:

21802

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	Appendix B and C	Interview Protocol and Consent Form	Appendix B and C - Interview Protocol and 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: 335

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 83 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	335	335
Annual IC Time Burden (Hours)	154	154
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Note to Reviewer - Pretesting 2019 CE Changes	Note to Reviewer - OMB CEQ and CED 2019.docx	01/09/2018

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