2019 VIUS Cognitive Testing

Generic Clearance for Internet Nonprobability Panel Pretesting

⚠️ Notice: This information collection may be referencing outdated material.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

Documents and Forms

Document Name Document Type
Form 1 2019 VIUS Cognitive Testing Form and Instruction
1 9501 VIUS Worksheet Attachment C - 9501 VIUS Worksheet.docx Form and Instruction
2 9502 VIUS Worksheet Attachment D - 9502 VIUS Worksheet.docx Form and Instruction
OMB Request - 2019 VIUS Cognitive Interviewing UPDATED.docx OMB Memo IC Document
Attachment A - Protocol 9501 Light Truck.docx Protocol for 9501 VIUS Worksheet IC Document
Attachment B - Protocol 9502 Tractor Trailer.docx Protocol for 9502 VIUS Worksheet IC Document
Attachment E - Classified Website Advertisement.docx Recruiting Ad IC Document
Attachment F - Consent form with letterhead (2).pdf Consent Form IC Document

Information Collection (IC) Details

IC Title:	2019 VIUS Cognitive Testing	Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	1	9501 VIUS Worksheet	Attachment C - 9501 VIUS Worksheet.docx		No		Fillable Fileable
Form and Instruction	2	9502 VIUS Worksheet	Attachment D - 9502 VIUS Worksheet.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: 90	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	90	90
Annual IC Time Burden (Hours)	113	113
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
OMB Memo	OMB Request - 2019 VIUS Cognitive Interviewing UPDATED.docx	12/12/2019
Protocol for 9501 VIUS Worksheet	Attachment A - Protocol 9501 Light Truck.docx	10/03/2019
Protocol for 9502 VIUS Worksheet	Attachment B - Protocol 9502 Tractor Trailer.docx	10/03/2019
Recruiting Ad	Attachment E - Classified Website Advertisement.docx	10/03/2019
Consent Form	Attachment F - Consent form with letterhead (2).pdf	10/03/2019

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