Cognitive Interviews for the CFS & PHSMA

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⚠️ Notice: This information collection may be referencing outdated material.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 Cognitive Interviews for the CFS & PHSMA Form and Instruction
1 PHMSA Data Collection Questionnaire Screenshots Attachment C_Screenshots Questionnaire Mock Up.docx Form and Instruction
2 2017 Commodity Flow Survey Paper Questionnaire Attachment D_ Commodity Flow Survey.pdf Form and Instruction
CFS_PHMSA OMB letter.docx OMB Memo IC Document
Attachment A_CFS PHMSA Protocol.docx Protocol IC Document
Attachment B_ Consent form with PRA content_21220.docx Consent Form IC Document

Information Collection (IC) Details

IC Title:	Cognitive Interviews for the CFS & PHSMA	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	PHMSA Data Collection Questionnaire Screenshots	Attachment C_Screenshots Questionnaire Mock Up.docx		No		Fillable Fileable
Form and Instruction	2	2017 Commodity Flow Survey Paper Questionnaire	Attachment D_ Commodity Flow Survey.pdf		No		Fillable Fileable

Line of Business: General Government

Subfunction: Central Records & Statistical Mgt

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 30	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	30	30
Annual IC Time Burden (Hours)	38	38
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
OMB Memo	CFS_PHMSA OMB letter.docx	05/11/2020
Protocol	Attachment A_CFS PHMSA Protocol.docx	05/11/2020
Consent Form	Attachment B_ Consent form with PRA content_21220.docx	05/11/2020

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