Generic Clearance for Questionnaire Pretesting Research

Forms and Documents

Document Name	Status
Form 1 Cognitive Testing of Supplemental Nutrition Assistance Program Client Integrity Messaging Form and Instruction	New
2022 Consent Form_071122.docx Supplementary Document	2022-09-22
2022 Spanish Universal Screener_220922_for OMB.docx Supplementary Document	2022-09-22
2022 Universal Screener_220915_for OMB_mc_clean.docx Supplementary Document	2022-09-22
KeyElements072015.docx Supplementary Document	2016-06-07
Supporting Statement Part B_082922.docx Supporting Statement B	2022-09-22
Supporting Statement Part A_220915_mc_clean.docx Supporting Statement A	2022-09-22

IC Document Collections

IC ID	Document Title	Status
257706	Cognitive Testing of Supplemental Nutrition Assistance Program Client Integrity Messaging Form and Instruction	New

ICR Details

OMB Control No: 0607-0725	ICR Reference No: 202209-0607-002
Status: Received in OIRA	Previous ICR Reference No: 201909-0607-002
Agency/Subagency: DOC/CENSUS	Agency Tracking No:
Title: Generic Clearance for Questionnaire Pretesting Research
Type of Information Collection: Extension without change of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular	Date Submitted to OIRA: 10/14/2022

	Requested	Previously Approved
Expiration Date	36 Months From Approved	12/31/2022
Responses	16,500	16,500
Time Burden (Hours)	16,500	16,500
Cost Burden (Dollars)	0	0

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Abstract: The research will be used by the Census Bureau and the survey sponsors to improve questionnaires and procedures, reduce respondent burden, and ultimately increase the quality of data collected in Census Bureau censuses and surveys. The clearance will be used to conduct pretesting of decennial, demographic, and economic census and survey questionnaires prior to fielding them. Pretesting activities will involve one of the following methods for identifying measurement problems with the questionnaire or survey procedure: cognitive interviews, focus groups, respondent debriefing, behavior coding of respondent/interviewer interaction, and split panel tests.

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Authorizing Statute(s): US Code: 13 USC 131, 141, 161, 181, 182, 193
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	87 FR 38703	06/29/2022
30-day Notice:	Federal Register Citation:	Citation Date:
	87 FR 62363	10/14/2022
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 0

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ICR Summary of Burden

	Total Request	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	16,500	16,500	0	0	0	0
Annual Time Burden (Hours)	16,500	16,500	0	0	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement:

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Annual Cost to Federal Government: $0

Does this IC contain surveys, censuses, or employ statistical methods? Yes Part B of Supporting Statement

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     Yes

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     Yes

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? No

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Common Form ICR:  No

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 10/14/2022

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