Information Collection

Race and Ethnicity Pilot Study

IC 261551 under ICR 202103-3045-003 · OMB 3045-0163.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3045-0163 can be found here:

Documents and Forms

Document Name Document Type
Form 3045-0163 Race and Ethnicity Pilot Study Form and Instruction
3045-0163 Race and Ethnicity Pilot Study Question Race and Ethnicity Pilot Question.docx Link will be sent to respondents by email Form and Instruction
Census Pilot Memo_SUBMISSION TO OMB.docx Study Description and Briefing IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Race and Ethnicity Pilot Study	Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	3045-0163	Race and Ethnicity Pilot Study Question	Race and Ethnicity Pilot Question.docx	Link will be sent to respondents by email	Yes	Yes	Fillable Fileable

Line of Business: Community and Social Services

Subfunction: Community and Regional Development

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 20,000	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	20,000	20,000
Annual IC Time Burden (Hours)	333	333
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Study Description and Briefing	Census Pilot Memo_SUBMISSION TO OMB.docx	08/18/2023

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