Information Collection

Testing of Proposed Revisions to the Identity Theft Supplement for the NCVS

IC 241319 under ICR 201902-1121-003 · OMB 1121-0339.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1121-0339 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
N/A Testing of Proposed Revisions to the Identity Theft Supplement for the NCVS	Form and Instruction
Cognitive Test Protocol Testing of Proposed Revisions to the Identity Theft Supplement for the NCVS	Form and Instruction
Online Questionnaire Testing of Proposed Revisions to the Identity Theft Supplement for the NCVS	Form and Instruction
Appendix 2. Cognitive interview recruitment screener.docx	Form and Instruction
Cognitive Test Protocol Appendix 4. Cognitive Interview Protocol.docx	Form and Instruction
Online Questionnaire Appendix 5. Online testing instruments.docx	Form and Instruction
1_ITS testing OMB generic clearance request_4.10.20.docx Memo to OMB on Identity Theft Supplement Test	IC Document
Appendix 1. MTurk_HIT.docx Amazon Mechanical Turk Postin	IC Document
Appendix 2. Cognitive interview recruitment screener.docx Cognitive Recruitment Screener	IC Document
Appendix 3a. Informed consent_INTERVIEWER.docx Informed Consent Interview	IC Document
Appendix 3b. Informed consent_PARTICIPANT.docx Informed Consent Participant	IC Document
Appendix 4. Cognitive Interview Protocol.docx Cognitive Interview Protocol	IC Document
Appendix 5. Online testing instruments.docx Online Testing Instruments	IC Document
Appendix 6. Informed consent_online testing.docx Informed Consent online testing	IC Document

IC Title:

Testing of Proposed Revisions to the Identity Theft Supplement for the NCVS

Agency IC Tracking Number:

BJS

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	N/A	Yes	Yes	Fillable Fileable
Form and Instruction	N/A	Yes	Yes	Fillable Fileable
Form and Instruction	N/A	Yes	Yes	Fillable Fileable

Line of Business: Law Enforcement

Subfunction: Crime Prevention

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 31,530

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 95 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	31,530	31,530
Annual IC Time Burden (Hours)	2,640	2,640
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Memo to OMB on Identity Theft Supplement Test		04/13/2020
Amazon Mechanical Turk Postin		04/13/2020
Cognitive Recruitment Screener		04/13/2020
Informed Consent Interview		04/13/2020
Informed Consent Participant		04/13/2020
Cognitive Interview Protocol		04/13/2020
Online Testing Instruments		04/13/2020
Informed Consent online testing		04/13/2020

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

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