Cover Letter

Request for Approval

TITLE OF INFORMATION COLLECTION: Respondent Perceptions of Burden in the American Community Survey (ACS)

PURPOSE: This planned evaluation consists of focus groups ranging in size from 3-12 respondents. In these focus groups, respondents who previously responded to the ACS will be asked about their experience with the ACS. The goal is to determine various aspects of the ACS that may contribute to respondents feeling burdened by the survey task, and possible ways in which these concerns could be measured with survey questions. The planned evaluation will focus on assessing the ACS respondent experience for the general population.

DESCRIPTION OF RESPONDENTS: A sample of previous respondents to the ACS

TYPE OF COLLECTION: (Check one)

[ ] Customer Comment Card/Complaint Form [ ] Customer Satisfaction Survey

[ ] Usability Testing (e.g., Website or Software [ ] Small Discussion Group

[x] Focus Group

[ ] Other:

CERTIFICATION:

I certify the following to be true:

1. The collection is voluntary.

2. The collection is low-burden for respondents and low-cost for the Federal Government.

3. The collection is non-controversial and does not raise issues of concern to other federal agencies.

4. The results are not intended to be disseminated to the public.

5. Information gathered will not be used for the purpose of substantially informing influential policy decisions.

6. The collection is targeted to the solicitation of opinions from respondents who have experience with the program or may have experience with the program in the future.

Name: ________________________________________________

To assist review, please provide answers to the following question:

Personally Identifiable Information:

1. Is personally identifiable information (PII) collected? [ ] Yes [x ] No

2. If Yes, will any information that is collected be included in records that are subject to the Privacy Act of 1974? [ ] Yes [ ] No

3. If Yes, has an up-to-date System of Records Notice (SORN) been published?

[ ] Yes [ ] No

Gifts or Payments:

Is an incentive (e.g., money or reimbursement of expenses, token of appreciation) provided to participants? [x ] Yes [ ] No

BURDEN HOURS

Category of Respondent	No. of Respondents	Participation Time	Burden
Screening: Ineligible	6,298	1 minute	115.5 hours
Screening: Eligible	72	6 minutes	7.2 hours
Focus Groups	72	2 hours	144 hrs
Total			266.7 hours

FEDERAL COST: The estimated annual cost to the Federal government is minimal.

If you are conducting a focus group, survey, or plan to employ statistical methods, please provide answers to the following questions:

The selection of your targeted respondents

1. Do you have a customer list or something similar that defines the universe of potential respondents and do you have a sampling plan for selecting from this universe?

[x ] Yes [ ] No

Census Bureau staff will sample respondents who responded to the ACS one to three months prior to the focus groups for three different areas of the country that will be selected based on the amount of sample available.

Focus groups will be stratified by mode of response, though some focus groups may include respondents from two different modes, depending on available sample.

Participants will be recruited by telephone by staff in the Census Bureau telephone centers. They may also receive an email reminder about the focus group after they agree to participate. We will provide the telephone center with the sample, a telephone script, and training. Copies of the telephone script is included in Enclosure 1.

This is a voluntary research study. Respondents can decline participation at any time.

Administration of the Instrument

1. How will you collect the information? (Check all that apply)

[ ] Web-based or other forms of Social Media

[ ] Telephone

[x ] In-person

[ ] Mail

[] Other:

2. Will interviewers or facilitators be used? [x ] Yes [ ] No

1.      Line of Business – General Government

2.      Subfunction - Central Records & Statistical Mgt

3.      Number of Respondents for small entity - 0

4.      Affected Public – Individuals and Households

5.      Percentage of respondents reporting electronically – 0%

Please submit all instruments, instructions, correspondences (emails, letters, etc.) to respondents, and scripts as separate documents along with this request document.

Every instrument must have the following displayed –

OMB Control No. 0690-0030

Expiration Date: 6/30/17