Information Collection

Boundary and Annexation Survey

IC 219080 under ICR 202012-0607-003 · OMB 0607-0151.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0607-0151 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form BAS-1 Boundary and Annexation Survey	Form
2021BAS-1L.pdf	Instruction
2021BAS-2L.pdf	Instruction
2021BAS-3L.pdf	Instruction
2021BAS-4L.pdf	Instruction
2021BAS-5L.pdf	Instruction
2021BAS-9L.pdf	Instruction
bas5i_18.pdf	Other-Insert - Materials Checklist
bas14i_18.pdf	Other-Insert - Response Methods Indi
bas15i_18.pdf	Other-Insert - Response Methods Geor
BAS-TribalFlyer_18.pdf	Other-BAS Tribal Flyer
BAS-Flyer_18.pdf	Other-BAS Flyer
2021BAS-E-1L.pdf	Instruction
2021BAS-E-2L.pdf	Instruction
2021BAS-E-3L.pdf	Instruction
2021BAS-E-4L.pdf	Instruction
2021BAS-E-5L.pdf	Instruction
2021BAS-E-HEOTC_CC.pdf	Other-Courtesy Email to HEO
2021BAS-E-PTR_YesChangeResponse.pdf	Instruction
2021BAS-E-SWIM-Token.pdf	Other-SWIM token
2021BAS-E-SWIM-HasAcct.pdf	Instruction
2021BAS-E-NRFU1 - No Response.pdf	Instruction
2021BAS-E-NRFU2 - Yes Change_No Sub.pdf	Instruction
2018_BAS_Email_State Agreement_FINAL.docx	Instruction
2018_BAS_Email_State Data Center_FINAL.docx	Instruction
BASSC 1L.docx	Instruction
BASSC 2L.docx	Instruction
BASSC 3L.docx	Instruction
19_BAS_RespondentGuide_State Certification_09052018.pdf	Other-State Certification Respondent
BASSC_Discrepancy_EmailBody_1.docx	Other-Email
BASSC_Discrepancy_EmailBody_2.docx	Other-Email
BASSC_SCO_EmailBody_text.docx	Other-Email
BAS16I.pdf	Other-Indiana Insert- 2020 Indiana s
2018_BAS_Email_BAS6L_Final.docx	Instruction
2018_BAS_Email_BAS7L_Final.docx	Instruction
Readme_BoundaryandAnnexationSurvey.txt	Instruction
ReadMe_BoundaryandAnnexationSurvey_GUPS.txt	Instruction
BASSC-4L_StateCert_SCO_Letter_MCD_09062018.docx	Instruction
BASSC-4L_StateCert_SCO_Letter_CCD_09062018.docx	Instruction
BASSC 4L.docx	Instruction
BAS-1 BAS 1 - Place Form BAS1.pdf www.census.gov/programs-surveys/bas.html	Form
BAS-2 BAS 2 - County Form BAS2.pdf www.census.gov/programs-surveys/bas.html	Form
BAS-3 BAS 3 - MCD Form BAS3.pdf www.census.gov/programs-surveys/bas.html	Form
BAS-5 BAS 5 - AIA Form BAS5.pdf www.census.gov/programs-surveys/bas.html	Form
BAS-6 BAS 6 - Consolidated BAS BAS6.pdf www.census.gov/programs-surveys/bas.html	Form
BAS-ARF BAS Annual Response Form BAS-ARF.pdf www.census.gov/programs-surveys/bas.html	Form
BASSC 1L State Certification Program BASSC 1L Form.pdf	Form
BASSC 2L Boundary Changes Not Reported to Census Bureau BASSC 2L Form.pdf	Form
BASSC State Certifying Official Sign-Up Form BASSC Form.pdf	Form
21_BASRespondentGuide_Paper_508.pdf BAS Paper Respondent Guide	IC Document
21_BASRespondentGuide_Digital_508.pdf BAS Digital Non-Tribal Respondent Guide	IC Document
21_BASRespondentGuide_TribalDigital_508.pdf BAS Digital Tribal Respondent Guide	IC Document
21_BASRespondent Guide_Digital_GUPS_508.pdf BAS GUPS Respondent Guide	IC Document
21_BASRespondentGuide_GUPSQuickStart_508.pdf BAS GUPS Quick Reference Guide	IC Document
21_BASRespondentGuide_DigitalQuickStart_508.pdf BAS Digital QuickStart	IC Document
21_BAS_RespondentGuide_Tribal_GUPS_508.pdf BAS Tribal GUPS	IC Document
21 BAS Partnership Tools_508.pdf BAS Partnership Tools	IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:

Boundary and Annexation Survey

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	BAS-1	BAS 1 - Place Form	BAS1.pdf	https://www.census.gov/programs-surveys/bas.html	Yes	Yes	Fillable Fileable
Form	BAS-2	BAS 2 - County Form	BAS2.pdf	https://www.census.gov/programs-surveys/bas.html	Yes	Yes	Fillable Fileable
Form	BAS-3	BAS 3 - MCD Form	BAS3.pdf	https://www.census.gov/programs-surveys/bas.html	Yes	Yes	Fillable Fileable
Form	BAS-5	BAS 5 - AIA Form	BAS5.pdf	https://www.census.gov/programs-surveys/bas.html	Yes	Yes	Fillable Fileable
Form	BAS-6	BAS 6 - Consolidated BAS	BAS6.pdf	https://www.census.gov/programs-surveys/bas.html	Yes	Yes	Fillable Fileable
Instruction			2021BAS-1L.pdf		Yes	Yes	Fillable Fileable
Instruction			2021BAS-2L.pdf		Yes	Yes	Fillable Fileable
Instruction			2021BAS-3L.pdf		Yes	Yes	Fillable Fileable
Instruction			2021BAS-4L.pdf		Yes	Yes	Fillable Fileable
Instruction			2021BAS-5L.pdf		Yes	Yes	Fillable Fileable
Instruction			2021BAS-9L.pdf		Yes	Yes	Fillable Fileable
Other-Insert - Materials Checklist			bas5i_18.pdf		Yes	Yes	Fillable Fileable
Other-Insert - Response Methods Indiana			bas14i_18.pdf		Yes	Yes	Fillable Fileable
Other-Insert - Response Methods Georgia			bas15i_18.pdf		Yes	Yes	Fillable Fileable
Other-BAS Tribal Flyer			BAS-TribalFlyer_18.pdf		No		Paper Only
Other-BAS Flyer			BAS-Flyer_18.pdf		No		Paper Only
Instruction			2021BAS-E-1L.pdf		Yes	Yes	Fillable Fileable
Instruction			2021BAS-E-2L.pdf		Yes	Yes	Fillable Fileable
Instruction			2021BAS-E-3L.pdf		Yes	Yes	Fillable Fileable
Instruction			2021BAS-E-4L.pdf		Yes	Yes	Fillable Fileable
Instruction			2021BAS-E-5L.pdf		Yes	Yes	Fillable Fileable
Other-Courtesy Email to HEO			2021BAS-E-HEOTC_CC.pdf		Yes	Yes	Fillable Fileable
Instruction			2021BAS-E-PTR_YesChangeResponse.pdf		Yes	Yes	Fillable Fileable
Other-SWIM token			2021BAS-E-SWIM-Token.pdf		Yes	Yes	Fillable Fileable
Instruction			2021BAS-E-SWIM-HasAcct.pdf		Yes	Yes	Fillable Fileable
Form	BAS-ARF	BAS Annual Response Form	BAS-ARF.pdf	https://www.census.gov/programs-surveys/bas.html	Yes	Yes	Fillable Fileable
Instruction			2021BAS-E-NRFU1 - No Response.pdf		Yes	Yes	Fillable Fileable
Instruction			2021BAS-E-NRFU2 - Yes Change_No Sub.pdf		Yes	Yes	Fillable Fileable
Instruction			2018_BAS_Email_State Agreement_FINAL.docx		Yes	Yes	Fillable Fileable
Instruction			2018_BAS_Email_State Data Center_FINAL.docx		Yes	Yes	Fillable Fileable
Form	BASSC 1L	State Certification Program	BASSC 1L Form.pdf		Yes	Yes	Fillable Fileable
Form	BASSC 2L	Boundary Changes Not Reported to Census Bureau	BASSC 2L Form.pdf		Yes	Yes	Fillable Fileable
Form	BASSC	State Certifying Official Sign-Up Form	BASSC Form.pdf		Yes	Yes	Fillable Fileable
Instruction			BASSC 1L.docx		Yes	Yes	Fillable Fileable
Instruction			BASSC 2L.docx		Yes	Yes	Fillable Fileable
Instruction			BASSC 3L.docx		Yes	Yes	Fillable Fileable
Other-State Certification Respondent Guide			19_BAS_RespondentGuide_State Certification_09052018.pdf		Yes	Yes	Paper Only
Other-Email			BASSC_Discrepancy_EmailBody_1.docx		Yes	Yes	Fillable Fileable
Other-Email			BASSC_Discrepancy_EmailBody_2.docx		Yes	Yes	Fillable Fileable
Other-Email			BASSC_SCO_EmailBody_text.docx		Yes	Yes	Fillable Fileable
Other-Indiana Insert- 2020 Indiana specific information			BAS16I.pdf		Yes	Yes	Fillable Fileable
Instruction			2018_BAS_Email_BAS6L_Final.docx		Yes	Yes	Fillable Fileable
Instruction			2018_BAS_Email_BAS7L_Final.docx		Yes	Yes	Fillable Fileable
Instruction			Readme_BoundaryandAnnexationSurvey.txt		Yes	Yes	Fillable Fileable
Instruction			ReadMe_BoundaryandAnnexationSurvey_GUPS.txt		Yes	Yes	Fillable Fileable
Instruction			BASSC-4L_StateCert_SCO_Letter_MCD_09062018.docx		Yes	Yes	Fillable Fileable
Instruction			BASSC-4L_StateCert_SCO_Letter_CCD_09062018.docx		Yes	Yes	Fillable Fileable
Instruction			BASSC 4L.docx		Yes	Yes	Fillable Fileable

Federal Enterprise Architecture Business Reference Module

Line of Business: General Government

Subfunction: Central Records & Statistical Mgt

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 84,465

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 75 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	84,465	84,465
Annual IC Time Burden (Hours)	170,056	170,056
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
BAS Paper Respondent Guide	21_BASRespondentGuide_Paper_508.pdf	12/09/2020
BAS Digital Non-Tribal Respondent Guide	21_BASRespondentGuide_Digital_508.pdf	12/09/2020
BAS Digital Tribal Respondent Guide	21_BASRespondentGuide_TribalDigital_508.pdf	12/09/2020
BAS GUPS Respondent Guide	21_BASRespondent Guide_Digital_GUPS_508.pdf	12/09/2020
BAS GUPS Quick Reference Guide	21_BASRespondentGuide_GUPSQuickStart_508.pdf	12/09/2020
BAS Digital QuickStart	21_BASRespondentGuide_DigitalQuickStart_508.pdf	12/09/2020
BAS Tribal GUPS	21_BAS_RespondentGuide_Tribal_GUPS_508.pdf	12/09/2020
BAS Partnership Tools	21 BAS Partnership Tools_508.pdf	12/09/2020

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