Information Collection

Cognitive Interview Data Collections for DOL Research

IC 266604 under ICR 202502-1290-004 · OMB 1290-0043.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1290-0043 can be found here:

Documents and Forms

Document Name Document Type
Appendix D Screener_4_3_v2_clean.docx forms.office.com/r/yaksEqb6PH Other-Screener
Appendix D Screener_4_3_v2_clean.docx forms.office.com/r/yaksEqb6PH Other-Screener
Appendix F National Worker Survey CI Guide_4_8_v2_clean.docx Other-Interview Guide
Appendix F National Worker Survey CI Guide_4_8_v2_clean.docx Other-Interview Guide
Appendix A WesInfo Advertisement.docx WesInfo Advertisement IC Document
Appendix A WesInfo Advertisement.docx WesInfo Advertisement IC Document
Appendix B Social Media Advertisement.docx Social Media Advertisement IC Document
Appendix B Social Media Advertisement.docx Social Media Advertisement IC Document
Appendix C E-mail to Worker Rights Organizations for Recruitment.docx E-mail to Worker Rights Organizations for Recruitment IC Document
Appendix C E-mail to Worker Rights Organizations for Recruitment.docx E-mail to Worker Rights Organizations for Recruitment IC Document
Appendix E Confirmation Email.docx Confirmation Email IC Document
Appendix E Confirmation Email.docx Confirmation Email IC Document
Appendix G Informed Consent_4_3.docx Informed Consent IC Document
Appendix G Informed Consent_4_3.docx Informed Consent IC Document
SSA Cognitive Interviews_Generic OMB_DOL Worker Survey_Westat edits.docx Supporting Statement Part A IC Document
SSA Cognitive Interviews_Generic OMB_DOL Worker Survey_Westat edits.docx Supporting Statement Part A IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Cognitive Interview Data Collections for DOL Research	Agency IC Tracking Number:

IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Screener			Appendix D Screener_4_3_v2_clean.docx	https://forms.office.com/r/yaksEqb6PH	Yes	Yes	Fillable Fileable
Other-Interview Guide			Appendix F National Worker Survey CI Guide_4_8_v2_clean.docx		Yes	Yes	Fillable Fileable

Line of Business: Workforce Management

Subfunction: Training and Employment

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 35	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Requested	Previously Approved
Annual Number of Responses for this IC	35	35
Annual IC Time Burden (Hours)	24	24
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
WesInfo Advertisement	Appendix A WesInfo Advertisement.docx	04/08/2024
Social Media Advertisement	Appendix B Social Media Advertisement.docx	04/08/2024
E-mail to Worker Rights Organizations for Recruitment	Appendix C E-mail to Worker Rights Organizations for Recruitment.docx	04/08/2024
Confirmation Email	Appendix E Confirmation Email.docx	04/08/2024
Informed Consent	Appendix G Informed Consent_4_3.docx	04/08/2024
Supporting Statement Part A	SSA Cognitive Interviews_Generic OMB_DOL Worker Survey_Westat edits.docx	04/08/2024

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