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2017 American Community Survey (ACS) Revised Mailing Materials Cognitive Interviews
Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery
OMB: 0690-0030
IC ID: 224257
OMB.report
DOC/OS
OMB 0690-0030
ICR 201402-0690-001
IC 224257
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0690-0030 can be found here:
2023-06-13 - Extension without change of a currently approved collection
2020-06-12 - Revision of a currently approved collection
Documents and Forms
Document Name
Document Type
Attachment IV - Consent Form.docx
Other-Consent Form
Attachment V - Recruitment Eligibility Screeners.docx
Other-Recruitment Eligibility Screen
ACS-M ACS Revised Mailing Material Protocol
Attachment III - ACS Revised Mailing Materials Protocol.docx
Form and Instruction
Attachment I - 2017 ACS Revised Mailing Materials.pdf
ACS Mailing Material
IC Document
Attachment II - Recruitment Advertisements.pdf
Recruitment Advertisements
IC Document
ACS Mail Materials OMB Memo_FINAL 102616.docx
OMB Memo
IC Document
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
2017 American Community Survey (ACS) Revised Mailing Materials Cognitive Interviews
Agency IC Tracking Number:
Census
IC Status:
New
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-Consent Form
Attachment IV - Consent Form.docx
Yes
No
Fillable Printable
Other-Recruitment Eligibility Screeners
Attachment V - Recruitment Eligibility Screeners.docx
Yes
No
Fillable Fileable
Form and Instruction
ACS-M
ACS Revised Mailing Material Protocol
Attachment III - ACS Revised Mailing Materials Protocol.docx
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:
140
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
0 %
Approved
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
140
0
140
0
0
0
Annual IC Time Burden (Hours)
39
0
39
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
ACS Mailing Material
Attachment I - 2017 ACS Revised Mailing Materials.pdf
11/02/2016
Recruitment Advertisements
Attachment II - Recruitment Advertisements.pdf
11/02/2016
OMB Memo
ACS Mail Materials OMB Memo_FINAL 102616.docx
11/02/2016
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.