Information Collection

Group Quarters

IC 227088 under ICR 201811-0607-010 · OMB 0607-0999.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form DH-20 Individual Census Questionnaire- English Group Quarters	Form
Form DH-20(S) Individual Census Questionnaire- Spanish Group Quarters	Form
Form DH-61(ICQ) Individual Census Questionnaire-Informational Copy Group Quarters	Form
Form DH-61(ICQ)S Individual Census Questionnaire-Informational Copy- Spanish Group Quarters	Form
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: Unchanged

Obligation to Respond: Mandatory

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	DH-20	No		Paper Only
Form	DH-20(S)	No		Paper Only
Form	DH-61(ICQ)	No		Paper Only
Form	DH-61(ICQ)S	No		Paper Only
Other-Envelope		No		Paper Only
Other-Envelope-eResponse		No		Paper Only
Other-Envelope		No		Paper Only
Other-Envelope		No		Paper Only
Other-Envelope- Spanish		No		Paper Only
Other-Brochure- Group Quarters Enumeration		No		Paper Only
Other-Brochure-Service-Based Enumeration		No		Paper Only
Other-Confidentiality Notice		No		Paper Only
Other-GQ Reinterview Form		No		Paper Only
Other-GQ Facility Manager Letter		No		Paper Only
Other-GQ Facility Manager Letter - English/Spanish		No		Paper Only
Other-GQ Facility Manager Letter- Engish/Spanish		No		Paper Only
Other-GQ Facility Manager Letter- English/Spanish		No		Paper Only
Other-Living Quarters Flashcard- English		No		Paper Only
Other-Living Quarters Flashcard- Spanish		No		Paper Only
Other-Enumeration Records		No		Paper Only
Other-GQ Advance Contact Call Script- Non-SBE GQ		No		Paper Only
Other-GQ Advance Contact Call Script-Emergency and Transitional Centers		No		Paper Only
Other-GQ Advance Contact Call Script- Mobile Food Vans		No		Paper Only
Other-GQ Advance Contact Call Script- Soup Kitchen		No		Paper Only
Other-eResponse Template		Yes	Yes	Fillable Fileable
Instruction		No		Paper Only
Other-Group Quarters Listing Sheet		No		Paper Only
Other-Group Quarters Enumerator Checklist		No		Paper Only
Other-Group Quarters Enumerator Checklist-Service Based Enumeration		No		Paper Only
Other-Group Quarters Enumeration-Census Field Supervisor Checklist		No		Paper Only
Other-Self-Enumerating Group Quarters-Facility Contact Checklist		No		Paper Only
Other-GQ Facility Manager Letter- eResponse		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	Previously Approved
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.

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