OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

Disability Perception Survey (DPS) - Web version

IC 251928 under ICR 202203-0960-002 · OMB unassigned.

Documents and Forms

Documents and forms in this information collection
Document NameDocument Type
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 Satement
Appendix A2_Privacy Act Statement.docx Other-Privacy Act Satement
Appendix B DPS item justification.docx Other-DPS Item Justication
Appendix B DPS item justification.docx Other-DPS Item Justication
Appendix C_AmeriSpeak’s Email Invitation script.docx Other-Email Invitation
Appendix C_AmeriSpeak’s Email Invitation script.docx Other-Email Invitation
Appendix E_Reminder to complete your AmeriSpeak survey.docx Other-Reminder email
Appendix E_Reminder to complete your AmeriSpeak survey.docx Other-Reminder email
Appendix F_Reminder 2_Another friendly reminder about your AmeriSpeak survey.docx Other-Friendly reminder to complete
Appendix F_Reminder 2_Another friendly reminder about your AmeriSpeak survey.docx Other-Friendly reminder to complete
Appendix G_Reminder 3_ Act now and receive 20,000 AmeriPoints.docx Other-Act Now reminder
Appendix G_Reminder 3_ Act now and receive 20,000 AmeriPoints.docx Other-Act Now reminder
Appendix H_Reminder 4_Your AmeriSpeak survey is ending soon.docx Other-Survey is ending soon
Appendix H_Reminder 4_Your AmeriSpeak survey is ending soon.docx Other-Survey is ending soon
Appendix I_Reminder 5_Time is running out.docx Other-Time is runnnint out screen
Appendix I_Reminder 5_Time is running out.docx Other-Time is runnnint out screen
Appendix J_“Last Chance” email script.docx Other-Last chance email
Appendix J_“Last Chance” email script.docx Other-Last chance email
Appendix K_ Partial_Reminder to Finish.docx Other-Paritial reminder to finish
Appendix K_ Partial_Reminder to Finish.docx Other-Paritial reminder to finish
Appendix L_AmeriSpeak’s text messaging prompting scripts.docx Other-Text message promptin script
Appendix L_AmeriSpeak’s text messaging prompting scripts.docx Other-Text message promptin 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

Information Collection (IC) Details

View Information Collection (IC)

layout table

Information Collection Instruments:
table that charts list of instruments
Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-DPS Survey Appendix A_DPS survey.docx Yes Yes Fillable Fileable
Other-Privacy Act Satement Appendix A2_Privacy Act Statement.docx No   Paper Only
Other-DPS Item Justication Appendix B DPS item justification.docx No   Paper Only
Other-Email Invitation Appendix C_AmeriSpeak’s Email Invitation script.docx Yes No Printable Only
Other-Reminder email Appendix E_Reminder to complete your AmeriSpeak survey.docx Yes No Printable Only
Other-Friendly reminder to complete survey Appendix F_Reminder 2_Another friendly reminder about your AmeriSpeak survey.docx Yes No Printable Only
Other-Act Now reminder Appendix G_Reminder 3_ Act now and receive 20,000 AmeriPoints.docx Yes No Printable Only
Other-Survey is ending soon Appendix H_Reminder 4_Your AmeriSpeak survey is ending soon.docx Yes No Printable Only
Other-Time is runnnint out screen Appendix I_Reminder 5_Time is running out.docx Yes No Printable Only
Other-Last chance email Appendix J_“Last Chance” email script.docx Yes No Printable Only
Other-Paritial reminder to finish Appendix K_ Partial_Reminder to Finish.docx Yes No Printable Only
Other-Text message promptin script Appendix L_AmeriSpeak’s text messaging prompting scripts.docx Yes Yes Fillable Fileable
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

Federal Enterprise Architecture Business Reference Module


table that charts list of burden
  Requested Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 4,259 0 4,259 0 0 0
Annual IC Time Burden (Hours) 1,207 0 1,207 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 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.