Information Collection

Disability Perception Survey (DPS) - Phone Version

IC 251927 under ICR 202203-0960-002 · OMB unassigned.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Appendix O _Telephone Interviewer FAQs.docx	Other-Telephone Inviewer FAQ
Appendix O _Telephone Interviewer FAQs.docx	Other-Telephone Inviewer FAQ
Appendix A_DPS survey.docx	Other-DPS survey
Appendix A_DPS survey.docx	Other-DPS survey
Appendix A2_Privacy Act Statement.docx	Other-Privacy Act Statement
Appendix A2_Privacy Act Statement.docx	Other-Privacy Act Statement
Appendix D_AmeriSpeak’s Telephone Invitation script.docx	Other-Telephone Invittion script
Appendix D_AmeriSpeak’s Telephone Invitation script.docx	Other-Telephone Invittion script
Appendix G_Reminder 3_ Act now and receive 20,000 AmeriPoints.docx	Other-Email Reminder Act Now
Appendix G_Reminder 3_ Act now and receive 20,000 AmeriPoints.docx	Other-Email Reminder Act Now
Appendix J_“Last Chance” email script.docx	Other-Last chance email script
Appendix J_“Last Chance” email script.docx	Other-Last chance email script
Appendix L_AmeriSpeak’s text messaging prompting scripts.docx	Other-Text message script
Appendix L_AmeriSpeak’s text messaging prompting scripts.docx	Other-Text message script
Appendix M_Post Card.docx	Other-Post Card
Appendix M_Post Card.docx	Other-Post Card
Appendix N_reminder letter with $2 included.docx	Other-reminder letter with $2
Appendix N_reminder letter with $2 included.docx	Other-reminder letter with $2

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Instrument File	Available Electronically?	Electronic Capability
Other-Telephone Inviewer FAQ	Appendix O _Telephone Interviewer FAQs.docx	No	Paper Only
Other-DPS survey	Appendix A_DPS survey.docx	No	Paper Only
Other-Privacy Act Statement	Appendix A2_Privacy Act Statement.docx	No	Paper Only
Other-Telephone Invittion script	Appendix D_AmeriSpeakâs Telephone Invitation script.docx	No	Paper Only
Other-Email Reminder Act Now	Appendix G_Reminder 3_ Act now and receive 20,000 AmeriPoints.docx	No	Paper Only
Other-Last chance email script	Appendix J_âLast Chanceâ email script.docx	No	Printable Only
Other-Text message script	Appendix L_AmeriSpeakâs text messaging prompting scripts.docx	No	Printable Only
Other-Post Card	Appendix M_Post Card.docx	No	Paper Only
Other-reminder letter with $2	Appendix N_reminder letter with $2 included.docx	No	Paper Only

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 752

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Requested	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	752	752
Annual IC Time Burden (Hours)	213	213
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.