Information Collection

Split Panel Test for Revised Survey Instrument--Respondents

IC 241357 under ICR 202201-0536-005 · OMB 0536-0043.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0536-0043 can be found here:

Documents and Forms

Document Name Document Type
Attachment A Test questionnaire CPS FSS.pdf Other-Survey Instrument
Attachment A Test questionnaire CPS FSS.pdf Other-Survey Instrument
Supplementary Supporting Statement for FSS Split Panel Test Part B.docx Supplementary Supporting Statement for FSS Split Panel Test Part B IC Document
Supplementary Supporting Statement for FSS Split Panel Test Part B.docx Supplementary Supporting Statement for FSS Split Panel Test Part B IC Document
Attachment B Federal Register for FSS Split Panel Test.pdf Attachment B Federal Register for FSS Split Panel Test IC Document
Attachment B Federal Register for FSS Split Panel Test.pdf Attachment B Federal Register for FSS Split Panel Test IC Document
Attachment D Cognitive Testing Recommendations.pdf Attachment D Cognitive Testing Recommendations IC Document
Attachment D Cognitive Testing Recommendations.pdf Attachment D Cognitive Testing Recommendations IC Document
Supplementary Supporting Statement for FSS Split Panel Test Part A_rev.docx Supplementary Supporting Statement for FSS Split Panel Test Part A IC Document
Supplementary Supporting Statement for FSS Split Panel Test Part A_rev.docx Supplementary Supporting Statement for FSS Split Panel Test Part A IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Split Panel Test for Revised Survey Instrument--Respondents	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Removed

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-Survey Instrument			Attachment A Test questionnaire CPS FSS.pdf		Yes	Yes	Fillable Fileable

Line of Business: Income Security

Subfunction: Food and Nutrition Assistance

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 31,200	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	-31,200	31,200
Annual IC Time Burden (Hours)	-4,599	4,599
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Supplementary Supporting Statement for FSS Split Panel Test Part B	Supplementary Supporting Statement for FSS Split Panel Test Part B.docx	04/15/2020
Attachment B Federal Register for FSS Split Panel Test	Attachment B Federal Register for FSS Split Panel Test.pdf	04/15/2020
Attachment D Cognitive Testing Recommendations	Attachment D Cognitive Testing Recommendations.pdf	04/15/2020
Supplementary Supporting Statement for FSS Split Panel Test Part A	Supplementary Supporting Statement for FSS Split Panel Test Part A_rev.docx	04/16/2020

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