Information Collection

Financial Well-Being Cognitive Testing

IC 255219 under ICR 201909-3170-002 · OMB 3170-0055.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3170-0055 can be found here:

Documents and Forms

Document Name Document Type
3170-0055 (Interview Questions).docx Other-interview questions
3170-0055 (Email and Screener).docx Other-introductory email and screene
3170-0055 supporting statement.docx 3170-0055 supporting statement IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Financial Well-Being 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
Other-interview questions			3170-0055 (Interview Questions).docx		No		Printable Only
Other-introductory email and screener questions			3170-0055 (Email and Screener).docx		Yes	Yes	Fillable Fileable

Line of Business: Economic Development

Subfunction: Financial Sector Oversight

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 263	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	263	263
Annual IC Time Burden (Hours)	112	112
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
3170-0055 supporting statement	3170-0055 supporting statement.docx	08/09/2022

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