Household Pulse Survey

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0607-1013 can be found here:

Documents and Forms

Document Name Document Type
Household Pulse Survey Form
Household Pulse Survey Questionnaire HH Pulse Survey Questionnaire_CLEAN FINAL_rev EDUC_041920.docx Form
Household Pulse Survey Questionnaire, Phase 3 Part A, ATTACH A_HH Pulse Questionnaire_Standard ICR_Phase 3_English_Spanish.pdf Form
Household Pulse Survey Questionnaire, Phase 3, Intent to Part A, ATTACH A_Household_Pulse_Survey_Phase3_Revised for Jan 6 2021.docx Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Household Pulse Survey	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	NA	Household Pulse Survey Questionnaire	HH Pulse Survey Questionnaire_CLEAN FINAL_rev EDUC_041920.docx	Yes	Yes	Fillable Fileable
Form	NA	Household Pulse Survey Questionnaire, Phase 3	Part A, ATTACH A_HH Pulse Questionnaire_Standard ICR_Phase 3_English_Spanish.pdf	Yes	Yes	Fillable Fileable
Form	NA	Household Pulse Survey Questionnaire, Phase 3, Intent to Vaccinate Update	Part A, ATTACH A_Household_Pulse_Survey_Phase3_Revised for Jan 6 2021.docx	Yes	Yes	Fillable Fileable

Line of Business: Workforce Management

Subfunction: Training and Employment

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 1,296,000	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Previously Approved
Annual Number of Responses for this IC	1,296,000	1,296,000
Annual IC Time Burden (Hours)	427,784	427,784
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

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