Additional Cognitive Testing for 2021 Household Survey

Information Collection for Qualitative Research

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3064-0198 can be found here:

Documents and Forms

Document Name Document Type
Form 2021 Household Sur Additional Cognitive Testing for 2021 Household Survey Form and Instruction
2021 Household Sur 2021 Unbanked Underbanked Household Survey Cognitive Tes hhsurvey_2021instrument_2020-10-30.docx Form and Instruction
Justification MM 0198 - Additional Cognitive Testing 2021 HH Survey.docx Justification Memo - Additional Cognitive Testing 2021 HH Survey IC Document

Information Collection (IC) Details

IC Title:	Additional Cognitive Testing for 2021 Household Survey	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	2021 Household Survey Cognitive	2021 Unbanked Underbanked Household Survey Cognitive Testing	hhsurvey_2021instrument_2020-10-30.docx		No		Paper Only

Line of Business: Economic Development

Subfunction: Financial Sector Oversight

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 15	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	15	15
Annual IC Time Burden (Hours)	20	20
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Justification Memo - Additional Cognitive Testing 2021 HH Survey	Justification MM 0198 - Additional Cognitive Testing 2021 HH Survey.docx	10/30/2020

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