Census Roster Omission Study

Generic Clearance for Questionnaire Pretesting Research

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0607-0725 can be found here:

Documents and Forms

Document Name Document Type
Form 1 Census Roster Omission Study Form and Instruction
1 Demographics Questionnaire 2. Demographics Questionnaire.docx Form and Instruction
2 Internet Use Questionnaire 3. Internet Use Questionnaire.docx Form and Instruction
3 Experimental Task Questionnaire 4. Experimental task Revised.docx Form and Instruction
4 Debriefing Questionnaire 5. Debriefing questions.docx Form and Instruction
OMB letter Revised.docx OMB Memo IC Document
1. Protocol Revised.docx Protocol IC Document

Information Collection (IC) Details

IC Title:	Census Roster Omission Study	Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Electronic Capability
Form and Instruction	1	Demographics Questionnaire	2. Demographics Questionnaire.docx	No	Fillable Fileable
Form and Instruction	2	Internet Use Questionnaire	3. Internet Use Questionnaire.docx	No	Fillable Fileable
Form and Instruction	3	Experimental Task Questionnaire	4. Experimental task Revised.docx	No	Fillable Fileable
Form and Instruction	4	Debriefing Questionnaire	5. Debriefing questions.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: 44 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	90	90
Annual IC Time Burden (Hours)	60	60
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
OMB Memo	OMB letter Revised.docx	01/07/2020
Protocol	1. Protocol Revised.docx	01/07/2020

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