Information Collection

Cognitive Testing

IC 198392 under ICR 201203-1121-001 · OMB 1121-0325.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1121-0325 can be found here:

Documents and Forms

Document Name Document Type
DOJ survey 2B_r1.pdf Other-Form: Mail Screener
DOJ survey 2C_r1.pdf Other-Form: Mail Screener
NCVS CS PILOT 2B Mail Screener Cognitive Interview Protocol Revised.docx Other-Interview Protocol
NCVS CS PILOT 2C Mail Screener Cognitive Interview Protocol Revised.docx Other-Interview Protocol
Appendix B Informed Consent Form.pdf Informed Consent Form IC Document
Appendix C Recruiting Advertisement Material.pdf Recruiting Advertisement Material IC Document
Appendix D Recruiting Script and Screener.pdf Recruiting Script and Screener IC Document
Appendix E Crime Scenarios for 2c Screener Testing.pdf Crime Scenarios for 2C Screener Testing IC Document
NCVS-CS - Project Summary.docx NCVS CS Project Summary IC Document
OMB_covermemo_cogs_Response_7 20.docx Qs and As between BJS and OMb IC Document
OMB MEMO for NCVS Cognitive Testing Revised.pdf Justification memo to OMB IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Cognitive Testing	Agency IC Tracking Number:	BJS

IC Status: Unchanged

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Instrument File	Available Electronically?	Electronic Capability
Other-Form: Mail Screener	DOJ survey 2B_r1.pdf	No	Paper Only
Other-Form: Mail Screener	DOJ survey 2C_r1.pdf	No	Paper Only
Other-Interview Protocol	NCVS CS PILOT 2B Mail Screener Cognitive Interview Protocol Revised.docx	No	Paper Only
Other-Interview Protocol	NCVS CS PILOT 2C Mail Screener Cognitive Interview Protocol Revised.docx	No	Paper Only

Line of Business: General Science and Innovation

Subfunction: Scientific and Technological Research and Innovation

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 150	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Requested	Previously Approved
Annual Number of Responses for this IC	150	150
Annual IC Time Burden (Hours)	79	79
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Informed Consent Form	Appendix B Informed Consent Form.pdf	07/05/2011
Recruiting Advertisement Material	Appendix C Recruiting Advertisement Material.pdf	07/05/2011
Recruiting Script and Screener	Appendix D Recruiting Script and Screener.pdf	07/05/2011
Crime Scenarios for 2C Screener Testing	Appendix E Crime Scenarios for 2c Screener Testing.pdf	07/05/2011
NCVS CS Project Summary	NCVS-CS - Project Summary.docx	07/05/2011
Qs and As between BJS and OMb	OMB_covermemo_cogs_Response_7 20.docx	07/27/2011
Justification memo to OMB	OMB MEMO for NCVS Cognitive Testing Revised.pdf	07/27/2011

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.