Addendum to 2020 Privacy and Confidentiality OMB Package

Generic Clearance for Census Bureau Field Tests and Evaluations

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0607-0971 can be found here:

Documents and Forms

Document Name Document Type
Form 1 Addendum to 2020 Privacy and Confidentiality OMB Package Form and Instruction
1 COVID Screening Statement Enclosure I COVID Screening Statement.docx Form and Instruction
Addendum Memo_09282020.docx OMB Memo IC Document
NOA.pdf Notice of Approval for Original Submission IC Document

Information Collection (IC) Details

IC Title:	Addendum to 2020 Privacy and Confidentiality OMB Package	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	COVID Screening Statement	Enclosure I COVID Screening Statement.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: 1	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	1	1
Annual IC Time Burden (Hours)	0	0
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
OMB Memo	Addendum Memo_09282020.docx	09/30/2020
Notice of Approval for Original Submission	NOA.pdf	09/28/2020

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