Information Collection Request

Household Pulse Survey

ICR 202012-0607-008 · OMB 0607-1013 · Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Household Pulse Survey Form Modified Available
Intent to vaccinate Question Pretest Memo_FINAL (1).docx Supplementary Document Uploaded 2020-12-31 Available
Attachment B_Vaccine Questions and Current Qx for Deletion_to OMB_122220.docx Supplementary Document Uploaded 2020-12-22 Available
Attachment A_Example Source and Accuracy Statement (week 20)_122220.pdf Supplementary Document Uploaded 2020-12-22 Available
Non Substantive Change HH Pulse Survey_Phase 3_final for OMB review_122220_vv.pdf Justification for No Material/Nonsubstantive Change Uploaded 2020-12-22 Repair queued
Part A, ATTACH F_Guiding Principles Experimental Statistical Products_053019.pdf Supplementary Document Uploaded 2020-10-30 Available
Part A, ATTACH A_HH Pulse Questionnaire_Standard ICR_Phase 3_English_Spanish.pdf Supplementary Document Uploaded 2020-09-15 Available
Part B ATTACH B_ HH Pulse Survey Weighting Plan_Standard ICR_Phase 3.docx Supplementary Document Uploaded 2020-09-15 Available
Part B ATTACH A HH Pulse_Contact Frame_Standard ICR_Phase 3.docx Supplementary Document Uploaded 2020-09-15 Available
Part A, ATTACH D_HH Pulse Public Facing Information via census.gov.pdf Supplementary Document Uploaded 2020-09-15 Available
Part A, ATTACH C_Respondent Contact_Phase 2_English_Spanish.docx Supplementary Document Uploaded 2020-09-15 Available
Part A, ATTACH B_PA and PRA Statement_Standard ICR Phase 3.docx Supplementary Document Uploaded 2020-09-15 Available
NSC Attachment 1_CE-DPINR Phase 2 Cog Testing Report_9.2.20.docx Supplementary Document Uploaded 2020-09-14 Available
Non Substantive Change HH Pulse Survey_Phase 2_091020 vv.pdf Supplementary Document Uploaded 2020-09-14 Available
Part A, ATTACH E_HH Pulse Public Facing Information via census.gov.pdf Supplementary Document Uploaded 2020-12-31 Available
Non Substantive Change_081220_Attach NSC-3_Part A, ATTACH C_Respondent Contact_Phase 2_English_Spanish.pdf Supplementary Document Uploaded 2020-08-13 Available
Non Substantive Change_081920_Attach NSC-1_Part A, ATTACH A_Questionnaire_Phase 2_English_Spanish.pdf Supplementary Document Uploaded 2020-08-19 Repair queued
Non Substantive Change HH Pulse Survey_081220_Sisson esign acting for Velkoff.pdf Justification for No Material/Nonsubstantive Change Uploaded 2020-08-13 Repair queued
Emergency Clearance Request Ltr_072320_Jarmin sig_ROCIS_submitted 073120.pdf Supplementary Document Uploaded 2020-07-31 Repair queued
Part B ATTACH B_ HH Pulse Survey Weighting Plan_Phase 2_ROCIS_submitted 073120.docx Supplementary Document Uploaded 2020-07-31 Available
Part B ATTACH A HH Pulse_Contact Frame_Phase 2_ROCIS_submitted 073120.docx Supplementary Document Uploaded 2020-07-31 Available
Part A, ATTACH D_Consolidated Comments Received to HH Pulse FRNs_ROCIS_revised_submitted 073120.pdf Supplementary Document Uploaded 2020-07-31 Repair queued
Part A, ATTACH C_Respondent Contact_Phase 2_ROCIS_revised_submitted 073120.docx Supplementary Document Uploaded 2020-07-31 Available
Part A, ATTACH B_PA and PRA Statement_Phase 2_ROCIS_submitted 073120.docx Supplementary Document Uploaded 2020-07-31 Available
Emergency Clearance Request Ltr_072320_Jarmin sig_ROCIS.pdf Supplementary Document Uploaded 2020-07-24 Repair queued
Part B ATTACH B_ HH Pulse Survey Weighting Plan_Phase 2_ROCIS.docx Supplementary Document Uploaded 2020-07-24 Available
Part B ATTACH A HH Pulse_Contact Frame_Phase 2_ROCIS.docx Supplementary Document Uploaded 2020-07-24 Available
Part A, ATTACH D_Consolidated Comments Received to HH Pulse FRNs_ROCIS.pdf Supplementary Document Uploaded 2020-07-24 Repair queued
Part A, ATTACH C_Respondent Contact_Phase 2_ROCIS.docx Supplementary Document Uploaded 2020-07-24 Available
Part A, ATTACH B_PA and PRA Statement_Phase 2_ROCIS.docx Supplementary Document Uploaded 2020-07-24 Repair queued
Household Pulse Survey Standard ICR_SupportingStatementB_rev 103020.docx Supporting Statement B Uploaded 2020-10-30 Available
Household Pulse Survey Standard ICR_SupportingStatementA_rev 123020.docx Supporting Statement A Uploaded 2020-12-31 Available

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
241411 Household Pulse Survey Form Modified

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
10/31/2023 10/31/2023 10/31/2023
1,296,000 0 1,296,000
427,784 0 427,784
0 0 0





Reginfo record details
1
table that charts list of burden
IC Title Form No. Form Name
Household Pulse Survey NA, NA, NA Household Pulse Survey Questionnaire ,   Household Pulse Survey Questionnaire, Phase 3 ,   Household Pulse Survey Questionnaire, Phase 3, Intent to Vaccinate Update

table that charts list of burden
  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 1,296,000 1,296,000 0 0 0 0
Annual Time Burden (Hours) 427,784 427,784 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No