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

U.S. Census Bureau, Center for Survey Measurement
a.

0978

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

c. DELEGATED

c. EXTENSION OF A CURRENTLY APPROVED COLLECTION

x

0607

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
NO
x
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

Generic Clearance for Internet Nonprobability Panel Pretesting
8. AGENCY FORM NUMBER(S) (if applicable)

9. KEYWORDS

10. ABSTRACT
The information collected in this program of developing and testing questionnaires and advertising that will be used by the Census Bureau to evaluate and improve
the quality of the data in the surveys and censuses that are ultimately conducted. Because the questionnaires being tested under this clearance are still in the process
of development, the data that result from these collections are not considered official statistics of the Census Bureau or other Federal agencies. Data will be included
in research reports prepared for sponsors inside and outside of the Census Bureau. The results may also be prepared for presentations related to survey methodology
at professional meetings or publications in professional journals.
11. AFFECTED PUBLIC (Mark primary with "P" and all others that apply with "X")
P

others that apply with "X")

d. FARMS

b. BUSINESS OR OTHER FOR-PROFIT

e. FEDERAL GOVERNMENT

c. NOT-FOR-PROFIT INSTITUTIONS

f. STATE, LOCAL OR TRIBAL GOVERNMENT

P

13. ANNUAL REPORTING AND RECORDKEEPING HOUR BURDEN
a. NUMBER OF RESPONDENTS
b. TOTAL ANNUAL RESPONSES
(1) Percentage of these responses collected electronically
c. TOTAL ANNUAL HOURS REQUESTED
d. CURRENT OMB INVENTORY
EXPLANATION OF
DIFFERENCE:

55,108
55,108
75
16,900
8,334

8566

e. DIFFERENCE (+, -)
f.

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

a. INDIVIDUALS OR HOUSEHOLDS

(1) Program change (+, -)
(2) Adustment (+, -)

b. REQUIRED TO OBTAIN OR RETAIN BENEFITS

b. TOTAL ANNUAL COSTS (O&M)
c. TOTAL ANNUALIZED COST REQUESTED
d. CURRENT OMB INVENTORY
e. DIFFERENCE (+, -)
f.

P

b. PROGRAM EVALUATION
c. GENERAL PURPOSE STATISTICS
d. AUDIT

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

YES

OMB FORM 83-I, 10/95

NO

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

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

X

e. PROGRAM PLANNING
OR MANAGEMENT

0.00
0.00
0.00

a. TOTAL CAPITAL/STARTUP COSTS

"P" and all others that apply with "X")
a. APPLICATION FOR BENEFITS

c. MANDATORY

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

8566

15. PURPOSE OF INFORMATION COLLECTION (Mark primary with

a. VOLUNTARY

x

f. RESEARCH
g. REGULATORY OR
COMPLIANCE

b. THIRD PARTY DISCLOSURE

c. REPORTING:

X

(1) On Occasion

(2) Weekly

(3) Monthly

(4) Quarterly

(5) Semi-Annually

(6) Annually

(7) Biennially

(8) Other (Describe)

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

Jennifer Hunter Childs

b. TELEPHONE NUMBER (Include area code)

202-603-4827

OMB CONTROL NUMBER

0607

0978

TITLE

Generic Clearance for Internet Nonprobability Panel Pretesting

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

Date

John Thompson, 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