OMB Form 83-I

PAPERWORK REDUCTION ACT SUBMISSION
Please read the instructions before completing this form. For additional forms or assistance in completing this form, contact your
agency's Paperwork Clearance Officer. Send two copies of this form, the collection instrument to be reviewed, the Supporting
Statement, and any additional documentation to: Office of Information and Regulatory Affairs, Office of Management and Budget,
Docket Library, Room 10102, 725 17th Street NW, Washington, DC 20503.
2. OMB CONTROL NUMBER

1. AGENCY/SUBAGENCY ORIGINATING REQUEST

DOC/Census/Associate Directorate Demographic Programs

a.

0354

b. NONE

4. TYPE OF REVIEW REQUESTED (X one)

3. TYPE OF INFORMATION COLLECTION (X one)

X
a. NEW COLLECTION

a. REGULAR SUBMISSION
b. EMERGENCY - APPROVAL REQUESTED BY:

b. REVISION OF A CURRENTLY APPROVED COLLECTION

X

0607

c. DELEGATED

c. EXTENSION OF A CURRENTLY APPROVED COLLECTION
d. REINSTATEMENT, WITHOUT CHANGE, OF A PREVIOUSLY
APPROVED COLLECTION FOR WHICH APPROVAL HAS EXPIRED

5. SMALL ENTITIES
Will this information collection have a significant economic
impact on a substantial number of small entities?

e. REINSTATEMENT, WITH CHANGE, OF A PREVIOUSLY
APPROVED COLLECTION FOR WHICH APPROVAL HAS EXPIRED

YES
X NO
6. REQUESTED EXPIRATION DATE

X

f. EXISTING COLLECTION IN USE WITHOUT AN OMB CONTROL
NUMBER

a. THREE YEARS FROM APPROVAL DATE
b. OTHER:

7. TITLE

Annual Social and Economic Supplement to the Current Population Survey
8. AGENCY FORM NUMBER(S) (if applicable)
CPS-580 (ASEC), CPS-580 (ASEC)SP, CPS-676, CPS-676(SP)
9. KEYWORDS

10. ABSTRACT
This supplement is the source of data on work experience, personal and family income, poverty levels, health insurance coverage, population status, family
relationships, and migration. These measurements will be analyzed with respect to each other as well as with demographic variables such as marital status,
education, age, and sex.

11. AFFECTED PUBLIC (Mark primary with "P" and all others that apply with "X")
P

a. INDIVIDUALS OR HOUSEHOLDS

P

e. FEDERAL GOVERNMENT

c. NOT-FOR-PROFIT INSTITUTIONS

f. STATE, LOCAL OR TRIBAL GOVERNMENT

a. NUMBER OF RESPONDENTS
b. TOTAL ANNUAL RESPONSES
(1) Percentage of these responses collected electronically
c. TOTAL ANNUAL HOURS REQUESTED
d. CURRENT OMB INVENTORY
e. DIFFERENCE (+, -)
EXPLANATION OF
DIFFERENCE:

78,000
78,000
100
32,500
32,500
0

a. TOTAL CAPITAL/STARTUP COSTS
c. TOTAL ANNUALIZED COST REQUESTED
d. CURRENT OMB INVENTORY
e. DIFFERENCE (+, -)
f.

(2) Adustment (+, -)

c. GENERAL PURPOSE STATISTICS
d. AUDIT

17. STATISTICAL METHODS
Does this information collection employ
statistical methods?

OMB FORM 83-I, 10/95

NO

f. RESEARCH
g. REGULATORY OR
COMPLIANCE

0.00
0.00

16. FREQUENCY OF RECORDKEEPING OR REPORTING (X all that apply)
a. RECORDKEEPING

X

b. PROGRAM EVALUATION

YES

EXPLANATION OF DIFFERENCE:
(1) Program change (+, -)

e. PROGRAM PLANNING
OR MANAGEMENT

0.00
0.00
0.00
0
0

b. TOTAL ANNUAL COSTS (O&M)

"P" and all others that apply with "X")

X

c. MANDATORY

(2) Adustment (+, -)

a. APPLICATION FOR BENEFITS

others that apply with "X")

14. ANNUALIZED COST TO RESPONDENTS (In thousands of dollars)

(1) Program change (+, -)

15. PURPOSE OF INFORMATION COLLECTION (Mark primary with

X
P

a. VOLUNTARY

b. REQUIRED TO OBTAIN OR RETAIN BENEFITS

b. BUSINESS OR OTHER FOR-PROFIT

13. ANNUAL REPORTING AND RECORDKEEPING HOUR BURDEN

f.

12. OBLIGATION TO RESPOND (Mark primary with "P" and all

d. FARMS

X

b. THIRD PARTY DISCLOSURE

c. REPORTING:
(1) On Occasion

(2) Weekly

(4) Quarterly

(5) Semi-Annually

(7) Biennially

(8) Other (Describe)

(3) Monthly

X

(6) Annually

18. AGENCY CONTACT (Person who can best answer questions regarding the content of this
submission)
a. NAME

Lisa A. Clement (Survey Operations)
Sharon M. Stern (Content)

b. TELEPHONE NUMBER (Include area code)

Mrs. Clement (301)763-3806
Mrs. Stern (301)763-5638

OMB CONTROL NUMBER

0607

0354

TITLE

Annual Social and Economic Supplement to the Current Population Survey

19. CERTIFICATION FOR PAPERWORK REDUCTION ACT SUBMISSIONS
a. PROGRAM OFFICIAL CERTIFICATION (Internal DOC Use Only)
Type name

Date

Enrique Lamas, Performing the Non-Exclusive Functions and Duties of the Deputy Director, U.S. Census
Bureau

On behalf of this Federal agency, I certify that the collection of information encompassed by this request
complies with 5 CFR 1320.9.
NOTE: The text of 5 CFR 1320.9, and the related provisions of 5 CFR 1320.8(b)(3), appear at the end of the
instructions. The certification is to be made with reference to those regulatory provisions as set forth in the
instructions.
The following is a summary of the topics, regarding the proposed collection of information, that the
certification covers:
(a) It is necessary for the proper performance of agency functions;
(b) It avoids unnecessary duplication;
(c) It reduces burden on small entities;
(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;
(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;
(f) It indicates the retention periods for recordkeeping requirements;
(g) It informs respondents of the information called for under 5 CFR 1320.8(b)(3) about:
(i)

Why the information is being collected;

(ii) Use of information;
(iii) Burden estimate;
(iv) Nature of response (voluntary, required for a benefit, or mandatory);
(v) Nature and extent of confidentiality; and
(vi) Need to display currently valid OMB control number;
(h) It was developed by an office that has planned and allocated resources for the efficient and effective
management and use of the information to be collected (see note in Item 19 of the instructions);
(i) If applicable, it uses effective and efficient statistical survey methodology; and
(j) It makes appropriate use of information technology.
If you are unable to certify compliance with any of these provisions, identify the item below and explain the
reason in Item 18 of the Supporting Statement.

b. SENIOR OFFICIAL OR DESIGNEE CERTIFICATION
Type name

Jennifer Jessup, Departmental Paperwork Clearance Officer
OMB FORM 83-I (BACK), 10/95

Date