New Experiment Questionnaire

Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery

Experiment QUESTIONNAIRE

Census Research Methodology Experiment

OMB: 0690-0030

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As you may know, the U.S. census is conducted every 10 years. This is your opportunity to provide input to the U.S. Census Bureau as we consider new ways to make it easier for people to participate in the census and other government surveys while maintaining or improving the quality of Census Bureau data.

The Census Bureau is considering using data that private businesses and other government organizations already collect about individuals and households to answer certain questions instead of asking people to answer these questions on a survey.

EACH SAMPLED RESPONDENT RECIEVES ONLY ONE OF THE FOLLOWING QUESTIONS:

  1. If you could save 10 minutes by allowing the Census Bureau to gather the number of household members at your address from other Federal government agencies, would you agree to letting the Census Bureau get that information, or would you prefer to spend the 10 minutes doing a survey?


  1. If you could save 30 minutes by allowing the Census Bureau to gather the number of household members at your address from other Federal government agencies, would you agree to letting the Census Bureau get that information, or would you prefer to spend the 30 minutes doing a survey?


  1. If you could save one hour by allowing the Census Bureau to gather the number of household members at your address from other Federal government agencies, would you agree to letting the Census Bureau get that information, or would you prefer to spend the hour doing a survey?


  1. If you could save 10 minutes by allowing the Census Bureau to gather dates of birth for all household members at your address from other Federal government agencies, would you agree to letting the Census Bureau get that information, or would you prefer to spend the 10 minutes doing a survey?


  1. If you could save 30 minutes by allowing the Census Bureau to gather dates of birth for all household members at your address from other Federal government agencies, would you agree to letting the Census Bureau get that information, or would you prefer to spend the 30 minutes doing a survey?


  1. If you could save one hour by allowing the Census Bureau to gather dates of birth for all household members at your address from other Federal government agencies, would you agree to letting the Census Bureau get that information, or would you prefer to spend the hour doing a survey?


  1. If you could save 10 minutes by allowing the Census Bureau to gather income for all household members at your address from other Federal government agencies, would you agree to letting the Census Bureau get that information, or would you prefer to spend the 10 minutes doing a survey?


  1. If you could save 30 minutes by allowing the Census Bureau to gather income for all household members at your address from other Federal government agencies, would you agree to letting the Census Bureau get that information, or would you prefer to spend the 30 minutes doing a survey?


  1. If you could save one hour by allowing the Census Bureau to gather income for all household members at your address from other Federal government agencies, would you agree to letting the Census Bureau get that information, or would you prefer to spend the hour doing a survey?


  1. If you could save 10 minutes by allowing the Census Bureau to gather the number of household members at your address from Stage Agencies, like the Department of Motor Vehicles, would you agree to letting the Census Bureau get that information, or would you prefer to spend the 10 minutes doing a survey?


  1. If you could save 30 minutes by allowing the Census Bureau to gather the number of household members at your address from Stage Agencies, like the Department of Motor Vehicles, would you agree to letting the Census Bureau get that information, or would you prefer to spend the 30 minutes doing a survey?


  1. If you could save one hour by allowing the Census Bureau to gather the number of household members at your address from Stage Agencies, like the Department of Motor Vehicles, would you agree to letting the Census Bureau get that information, or would you prefer to spend the hour doing a survey?


  1. If you could save 10 minutes by allowing the Census Bureau to gather dates of birth for all household members at your address from Stage Agencies, like the Department of Motor Vehicles, would you agree to letting the Census Bureau get that information, or would you prefer to spend the 10 minutes doing a survey?


  1. If you could save 30 minutes by allowing the Census Bureau to gather dates of birth for all household members at your address from Stage Agencies, like the Department of Motor Vehicles, would you agree to letting the Census Bureau get that information, or would you prefer to spend the 30 minutes doing a survey?


  1. If you could save one hour by allowing the Census Bureau to gather dates of birth for all household members at your address from other Federal government agencies, would you agree to letting the Census Bureau get that information, or would you prefer to spend the hour doing a survey?





  1. If you could save 10 minutes by allowing the Census Bureau to gather income for all household members at your address from other Stage Agencies, like the Department of Motor Vehicles, would you agree to letting the Census Bureau get that information, or would you prefer to spend the 10 minutes doing a survey?


  1. If you could save 30 minutes by allowing the Census Bureau to gather income for all household members at your address from Stage Agencies, like the Department of Motor Vehicles, would you agree to letting the Census Bureau get that information, or would you prefer to spend the 30 minutes doing a survey?


  1. If you could save one hour by allowing the Census Bureau to gather income for all household members at your address from Stage Agencies, like the Department of Motor Vehicles, would you agree to letting the Census Bureau get that information, or would you prefer to spend the hour doing a survey?


  1. If you could save 10 minutes by allowing the Census Bureau to gather the number of household members at your address from commercial firms, would you agree to letting the Census Bureau get that information, or would you prefer to spend the 10 minutes doing a survey?


  1. If you could save 30 minutes by allowing the Census Bureau to gather the number of household members at your address from commercial firms, would you agree to letting the Census Bureau get that information, or would you prefer to spend the 30 minutes doing a survey?


  1. If you could save one hour by allowing the Census Bureau to gather the number of household members at your address from commercial firms, would you agree to letting the Census Bureau get that information, or would you prefer to spend the hour doing a survey?


  1. If you could save 10 minutes by allowing the Census Bureau to gather dates of birth for all household members at your address from commercial firms, would you agree to letting the Census Bureau get that information, or would you prefer to spend the 10 minutes doing a survey?


  1. If you could save 30 minutes by allowing the Census Bureau to gather dates of birth for all household members at your address from commercial firms, would you agree to letting the Census Bureau get that information, or would you prefer to spend the 30 minutes doing a survey?


  1. If you could save one hour by allowing the Census Bureau to gather dates of birth for all household members at your address from commercial firms, would you agree to letting the Census Bureau get that information, or would you prefer to spend the hour doing a survey?

  2. If you could save 10 minutes by allowing the Census Bureau to gather income for all household members at your address from commercial firms, would you agree to letting the Census Bureau get that information, or would you prefer to spend the 10 minutes doing a survey?


  1. If you could save 30 minutes by allowing the Census Bureau to gather income for all household members at your address from commercial firms, would you agree to letting the Census Bureau get that information, or would you prefer to spend the 30 minutes doing a survey?


  1. If you could save one hour by allowing the Census Bureau to gather income for all household members at your address from commercial firms, would you agree to letting the Census Bureau get that information, or would you prefer to spend the hour doing a survey?


ALL RESPONDENTS:

2

Are you male or female?

Male

Female



3

What is your age?

Less the 18 years old

18-24

25-34

35-44

45-54

55-64

65 -74

75 or older



4

Are you of Hispanic or Latino origin?

Yes > SHOW: “Hispanics can be any race” in Q10

No



5

(IF HISPANIC – YES IN Q9 - SHOW: “Hispanics can be of any race.”) What is your race? You may select one or more.

White

Black or African American

American Indian or Alaska Native

Asian

Native Hawaiian or other Pacific Islander

6

What is your highest level of education?

Less than high school diploma or GED

High school diploma or GED

Some college

College graduate or professional degree



7

Last week, did you work for pay at a job (or business)?

Yes

No







GO TO CLOSE

CLOSE. Thank you very much for participating in this important study. Your responses will be extremely helpful to the U.S. Census Bureau.





File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
AuthorCasey M Eggleston
File Modified0000-00-00
File Created2021-01-28

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