Information Collection

2025 Area Screening Survey, a pilot study for the June Area Survey

IC 277283 under ICR 202412-0535-002 · OMB 0535-0264.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0535-0264 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form SurveyID 2025 Area Screening Survey, a pilot study for the June Area Survey	Form and Instruction
SurveyID 2025 Area Screener NY IL TX Version 0264 - June Area Screener Pilot Questionnaire to OMB NY IL TX _v2.pdf	Form and Instruction
SurveyID 2025 Area Screener CO, OR Version 0264- June Area Screener Pilot Questionnaire to OMB CO OR_v2.pdf	Form and Instruction
0264 - 20XX Sample Reminder Text Message Sent to Respondents - July 08, 2025.docx 0264 - Sample Reminder Text Message Sent to Respondents	IC Document
0264 - 2025 Area Sample Reminder E-Mail.docx 0264 - 2025 Area Sample Reminder E-Mail	IC Document
0264 - Area Map example - 1.pdf 0264 - Area Map example - 1	IC Document
0264 - Area Map example - 2.pdf 0264 - Area Map example - 2	IC Document
0264 - Area Map example - 3.pdf 0264 - Area Map example - 3	IC Document
0264 - 2025 Area Screening Survey, a pilot study for the June Area Survey - SSB - 2025.docx 0264 - 2025 Area Screening Survey, a pilot study for the June Area Survey - SSB - 2025	IC Document
0264 - 2025 Area Screening Survey, a pilot study for the June Area Survey - SSA - 2025.docx 0264 - 2025 Area Screening Survey, a pilot study for the June Area Survey - SSA - 2025	IC Document
0264 - 2025_Area_Screening_Survey_Cover_Letter_.docx 0264 - 2025 Area Screener Survey Cover Letter	IC Document

IC Title:

2025 Area Screening Survey, a pilot study for the June Area Survey

Agency IC Tracking Number:

IC Status: New

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	SurveyID	2025 Area Screener NY IL TX Version	0264 - June Area Screener Pilot Questionnaire to OMB NY IL TX _v2.pdf		Yes	Yes	Fillable Fileable
Form and Instruction	SurveyID	2025 Area Screener CO, OR Version	0264- June Area Screener Pilot Questionnaire to OMB CO OR_v2.pdf		Yes	Yes	Fillable Fileable

Line of Business: Economic Development

Subfunction: Industry Sector Income Stabilization

Privacy Act System of Records

Title: SORN

FR Citation: 74 FR 79

Number of Respondents: 12,000

Number of Respondents for Small Entity: 10,200

Affected Public: Private Sector

Private Sector: Businesses or other for-profits, Farms

Percentage of Respondents Reporting Electronically: 5 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	19,850	19,850
Annual IC Time Burden (Hours)	3,540	3,540
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
0264 - Sample Reminder Text Message Sent to Respondents	0264 - 20XX Sample Reminder Text Message Sent to Respondents - July 08, 2025.docx	08/28/2025
0264 - 2025 Area Sample Reminder E-Mail	0264 - 2025 Area Sample Reminder E-Mail.docx	08/28/2025
0264 - Area Map example - 1	0264 - Area Map example - 1.pdf	08/28/2025
0264 - Area Map example - 2	0264 - Area Map example - 2.pdf	08/28/2025
0264 - Area Map example - 3	0264 - Area Map example - 3.pdf	08/28/2025
0264 - 2025 Area Screening Survey, a pilot study for the June Area Survey - SSB - 2025	0264 - 2025 Area Screening Survey, a pilot study for the June Area Survey - SSB - 2025.docx	08/28/2025
0264 - 2025 Area Screening Survey, a pilot study for the June Area Survey - SSA - 2025	0264 - 2025 Area Screening Survey, a pilot study for the June Area Survey - SSA - 2025.docx	08/28/2025
0264 - 2025 Area Screener Survey Cover Letter	0264 - 2025_Area_Screening_Survey_Cover_Letter_.docx	08/28/2025

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