Information Collection

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

IC 277283 under ICR 202601-0535-029 · OMB 0535-0264.

Documents and Forms

Documents and forms in this information collection
Document NameDocument Type
Form SurveyID
2025 Area Screening Survey, a pilot study for the June Area Survey
Form and Instruction
Form SurveyID
2025 Area Screener NY IL TX Version 2025 Area Screening Survey, a pilot study for the June Area Survey
Form and Instruction
Form SurveyID
2025 Area Screener CO, OR Version 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 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
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 - 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 - 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 - 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 - 2.pdf
0264 - Area Map example - 2
IC Document
0264 - Area Map example - 3.pdf
0264 - Area Map example - 3
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 - 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, 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
0264 - 2025_Area_Screening_Survey_Cover_Letter_.docx
0264 - 2025 Area Screener Survey Cover Letter
IC Document

Information Collection (IC) Details

View Information Collection (IC)

layout table

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 Yes Yes Fillable Fileable
Form and Instruction SurveyID Yes Yes Fillable Fileable

Federal Enterprise Architecture Business Reference Module


table that charts list of burden
  Requested Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 19,850 0 0 0 0 19,850
Annual IC Time Burden (Hours) 3,540 0 0 0 0 3,540
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Documents for IC
table that charts IC Documents
Title Document Date Uploaded
0264 - Sample Reminder Text Message Sent to Respondents 08/28/2025
0264 - 2025 Area Sample Reminder E-Mail 08/28/2025
0264 - Area Map example - 1 08/28/2025
0264 - Area Map example - 2 08/28/2025
0264 - Area Map example - 3 08/28/2025
0264 - 2025 Area Screening Survey, a pilot study for the June Area Survey - SSB - 2025 08/28/2025
0264 - 2025 Area Screening Survey, a pilot study for the June Area Survey - SSA - 2025 08/28/2025
0264 - 2025 Area Screener Survey Cover Letter 08/28/2025
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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