Information Collection

Household Pulse Survey

IC 241411 under ICR 202012-0607-008 · OMB 0607-1013.

⚠️ Notice: This information collection may be referencing outdated material.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

Documents and Forms

Documents and forms in this information collection
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

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:

table that charts list of 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 %

table that charts list of burden
	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

table that charts IC Documents
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.