Information Collection

Cognitive testing for the 2023 Survey of Sexual Victimization

IC 258114 under ICR 202409-1121-002 · OMB 1121-0339.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1121-0339 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Cognitive testing for the 2023 Survey of Sexual Victimization	Form and Instruction
Protocol for Cognitive Interview for 2023 Survey of Sexu Attachment A_SSV Protocol for Cognitive Testing_Amended race and ethnicity.docx	Form and Instruction
Survey instrument Attachment E. SSV Survey Instruments_Amended race and ethnicity.pdf	Form and Instruction
OMB Generic Clearance Request for SSV Cognitive Testing_Amended race and ethnicity.docx Memo to OMB on SSV Cognitive Interview	IC Document
Attachments B to E.pdf Attachments for Generic Clearance	IC Document

IC Title:

Cognitive testing for the 2023 Survey of Sexual Victimization

Agency IC Tracking Number:

BJS

IC Status: Unchanged

Obligation to Respond: Voluntary

CFR Citation:

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
Form and Instruction	N/A	Protocol for Cognitive Interview for 2023 Survey of Sexual Victimization	Attachment A_SSV Protocol for Cognitive Testing_Amended race and ethnicity.docx		Yes	Yes	Fillable Fileable
Form and Instruction	N/A	Survey instrument	Attachment E. SSV Survey Instruments_Amended race and ethnicity.pdf		Yes	Yes	Fillable Fileable

Line of Business: Correctional Activities

Subfunction: Criminal Incarceration

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 40

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 90 %

table that charts list of burden
	Requested	Previously Approved
Annual Number of Responses for this IC	40	40
Annual IC Time Burden (Hours)	40	40
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Memo to OMB on SSV Cognitive Interview	OMB Generic Clearance Request for SSV Cognitive Testing_Amended race and ethnicity.docx	02/13/2023
Attachments for Generic Clearance	Attachments B to E.pdf	02/13/2023

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