Information Collection

Cognitive testing for the 2023 Race and Ethnicity Questions: Census Household

IC 259371 under ICR 202508-0607-002 · OMB 0607-0725.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0607-0725 can be found here:

2025-12-30 - Revision of a currently approved collection

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form Protocol Cognitive testing for the 2023 Race and Ethnicity Questions: Census Household	Form
Form Protocol Protocol Cognitive testing for the 2023 Race and Ethnicity Questions: Census Household	Form
Form Version A Version A Cognitive testing for the 2023 Race and Ethnicity Questions: Census Household	Form
Form Version B Version B Cognitive testing for the 2023 Race and Ethnicity Questions: Census Household	Form
Form Screener Screener Cognitive testing for the 2023 Race and Ethnicity Questions: Census Household	Form
Form Consent Consent Cognitive testing for the 2023 Race and Ethnicity Questions: Census Household	Form and Instruction
Protocol Protocol Attachment A Cognitive Interview Protocol - 2023 Race-Ethnicity Question Testing_03242023_rev.docx	Form
Protocol Protocol Attachment A Cognitive Interview Protocol - 2023 Race-Ethnicity Question Testing_03242023_rev.docx	Form
Version A Version A Attachment B RE_Vertical_Question_Testing_Instrument_rev.docx	Form
Version A Version A Attachment B RE_Vertical_Question_Testing_Instrument_rev.docx	Form
Version B Version B Attachment C RE_Two_Page_Question_Testing_Instrument-1_rev.docx	Form
Version B Version B Attachment C RE_Two_Page_Question_Testing_Instrument-1_rev.docx	Form
Screener Screener Attachment E RE_Testing_ENGLISH_Draft Screener Specs_032722_rev.docx	Form
Screener Screener Attachment E RE_Testing_ENGLISH_Draft Screener Specs_032722_rev.docx	Form
Consent Consent Attachment D Draft Consent Form_rev.docx	Form and Instruction
Consent Consent Attachment D Draft Consent Form_rev.docx	Form and Instruction
2023 Race and Ethnicity Testing OMB Request Letter-1_rev.docx Memo	IC Document
2023 Race and Ethnicity Testing OMB Request Letter-1_rev.docx Memo	IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:

Cognitive testing for the 2023 Race and Ethnicity Questions: Census Household

Agency IC Tracking Number:

IC Status: Unchanged

Obligation to Respond: Voluntary

CFR Citation: 13 CFR 131, 141, 182, 193, 196 (To search for a specific CFR, visit the Code of Federal Regulations.)

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	Protocol	Yes	Yes	Fillable Fileable
Form	Version A	Yes	Yes	Fillable Fileable
Form	Version B	Yes	Yes	Fillable Fileable
Form	Screener	Yes	Yes	Fillable Fileable
Form and Instruction	Consent	Yes	Yes	Fillable Fileable

Federal Enterprise Architecture Business Reference Module

Line of Business: General Government

Subfunction: Central Records & Statistical Mgt

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 115

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Requested	Previously Approved
Annual Number of Responses for this IC	115	115
Annual IC Time Burden (Hours)	132	132
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Memo		03/29/2023

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

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