Household Pulse Survey

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Household Pulse Survey	Form	New	Repair queued
HH Pulse Survey Questionnaire_CLEAN FINAL_041820_w_EDUC.docx	Supplementary Document	Uploaded 2020-04-18	Repair queued
Emergency Clearance Request Ltr_041520_RJarmin esig.pdf	Supplementary Document	Uploaded 2020-04-18	Repair queued
Part B ATTACH B_ HH Pulse Survey_Weighting.docx	Supplementary Document	Uploaded 2020-04-18	Repair queued
Part B ATTACH A HH Pulse_Contact Frame.docx	Supplementary Document	Uploaded 2020-04-18	Repair queued
Part A, ATTACH E_Addl Supporting Documentation_to OMB 041720.docx	Supplementary Document	Uploaded 2020-04-18	Repair queued
Part A, ATTACH D_Guiding principles BOC Experimental Series_053019.pdf	Supplementary Document	Uploaded 2020-04-18	Repair queued
Part A, ATTACH C_Respondent Contact.docx	Supplementary Document	Uploaded 2020-04-18	Repair queued
Part A, ATTACH B_PA and PRA Statement.docx	Supplementary Document	Uploaded 2020-04-18	Repair queued
COVID Census HH Contents_04182020_FINAL_w_ED_CHNGS.xlsx	Supplementary Document	Uploaded 2020-04-18	Repair queued
PART B_HH Pulse Survey_to OMB_041720_rev7PM 1.docx	Supporting Statement B	Uploaded 2020-04-18	Repair queued
PART A_ Household Pulse Survey_to OMB_041720_7PM.docx	Supporting Statement A	Uploaded 2020-04-18	Repair queued

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
241398	Household Pulse Survey	Form	New

ICR Details

OMB Control No:	ICR Reference No: 202004-0607-004
Status: Historical Inactive	Previous ICR Reference No:
Agency/Subagency: DOC/CENSUS	Agency Tracking No:
Title: Household Pulse Survey
Type of Information Collection: New collection (Request for a new OMB Control Number)	Common Form ICR:  No
Type of Review Request: Emergency	Approval Requested By: 04/19/2020
OIRA Conclusion Action: Improperly submitted	Conclusion Date: 04/19/2020
	Date Received in OIRA: 04/19/2020
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date		6 Months From Approved
Responses	0	0	0
Time Burden (Hours)	0	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: The U. S. Census Bureau in consultation with its federal statistical partners endeavors to pilot a rapid response Household Pulse Survey in order to produces and disseminate data about the health, social, and economic characteristics of American households as they experience the COVID-19 epidemic. This is a short-term, urgent endeavor designed to maximize the federal statistical system in addressing these emergent data needs. Given the rapidly changing dynamics of this situation for American households, there is an acute need for data that shed light on the situation as it is unfolding. Approval of this information collection is requested by April 17, 2020.

Emergency Justfication: The effects of the Covid-19 pandemic will be felt for months, possibly years, to come. The federal statistical community is developing questions for inclusion in the government’s large, benchmark surveys for later this year. However, given the rapidly changing dynamics of this situation, we must respond to the acute need for data on the situation as it is unfolding now. These rapid response data will provide federal, state and local agencies critical information to guide real-time response and interventions. In order to respond to these needs, the Census Bureau cannot reasonably comply with the normal clearance process and requests emergency clearance.

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Authorizing Statute(s): US Code: 13 USC Sections 8(b), 182 and 196 Name of Law: null
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments

Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 1

table that charts list of burden

IC Title	Form No.	Form Name
Household Pulse Survey	NA	Household Pulse Survey Questionnaire

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Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: The increase in burden is due to the fact that this is a new information collection.

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Annual Cost to Federal Government: $1,232,825

Does this IC contain surveys, censuses, or employ statistical methods? No

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     Yes

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     Yes

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Yes

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Common Form ICR:  No

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 04/19/2020

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