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Web Survey Design IOE Qualtrics Landing Screen Text (2).docx

Generic Clearance for Questionnaire Pretesting Research

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OMB: 0607-0725

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Web Survey Design IOE

(combined PA Statement & PRA Burden Statement)

(POC: Jenny Hunter-Childs)




The U.S. Census Bureau is required by law to protect your information. The Census Bureau is not permitted to publicly release your responses in a way that could identify you. We are conducting this voluntary survey under the authority of Title 13, United States Code, Sections 8(b), 182, and 196. Federal law protects your privacy and keeps your answers confidential (Title 13, United States Code, Section 9). Per the Federal Cybersecurity Enhancement Act of 2015, your data are protected from cybersecurity risks through screening of the systems that transmit your data.

 We estimate that completing this survey will take 10 minutes on average. Send comments regarding this estimate or any other aspect of this survey, including suggestions for reducing the time it takes to complete this survey to adrm.pra@census.gov. This collection has been approved by the Office of Management and Budget (OMB). This eight-digit OMB approval number, 0607-0725, confirms this approval and expires on 12/31/2022. We are required to display this number to conduct this survey. By proceeding, you give your consent to participate in this study.

Your privacy is protected by the Privacy Act. The information provided may be shared with other Census Bureau staff for the work-related purposes identified in this statement. For more information on this collection, see SORN “CENSUS-3, Demographic Survey Collection (Census Bureau Sampling Frame)”  by visiting our website at census.gov and click on "Data Protection and Privacy Policy" at the bottom of the home page.



File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
AuthorEdwina Martha Jaramillo (CENSUS/PCO FED)
File Modified0000-00-00
File Created2021-01-16

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