Information Collection

Census Roster Omission Study

IC 239187 under ICR 201909-0607-002 · OMB 0607-0725.

⚠️ Notice: This information collection may be referencing outdated material.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

Documents and Forms

Documents and forms in this information collection
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

IC Title:

Census Roster Omission Study

Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of 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 %

table that charts list of burden
	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

table that charts IC Documents
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.