Information Collection

2013 CPS ASEC Content Test

IC 204710 under ICR 201211-0607-002 · OMB 0607-0973.

Documents and Forms

Document Name Document Type
Form Items Booklet - In 2013 CPS ASEC Content Test Form
B. Confidentiality brochure.pdf Other-Confidentiality Brochure
C. CPS ASEC Advanced letter.docx Other-Advance Letter
E. Survey instrument flow document v7.vsd Other-Survey Instrument Flow Documen
F. CPS ASEC 2013 flow doc_v25.docx Other-Survey Instrument Path Diagram
M. Scripted scenario health insurance.docx Other-Scripted Scenario - Health Ins
Items Booklet - He Items Booklet - Health Insurance D. Items Booklet - health insurance.pdf Form
Items Booklet - In Items Booklet - Income & Other Questions G. Items Booklet - Income v2.pdf Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	2013 CPS ASEC Content Test	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	Items Booklet - Income & Other Questions	Items Booklet - Income & Other Questions	G. Items Booklet - Income v2.pdf	Yes	Yes	Fillable Fileable
Other-Survey Instrument Flow Document			E. Survey instrument flow document v7.vsd	Yes	Yes	Fillable Fileable
Other-Survey Instrument Path Diagrams			F. CPS ASEC 2013 flow doc_v25.docx	Yes	Yes	Fillable Fileable
Other-Confidentiality Brochure			B. Confidentiality brochure.pdf	Yes	Yes	Fillable Fileable
Form	Items Booklet - Health Insurance	Items Booklet - Health Insurance	D. Items Booklet - health insurance.pdf	Yes	Yes	Fillable Fileable
Other-Advance Letter			C. CPS ASEC Advanced letter.docx	Yes	Yes	Fillable Fileable
Other-Scripted Scenario - Health Insurance Module			M. Scripted scenario health insurance.docx	Yes	Yes	Fillable Fileable

Line of Business: General Government

Subfunction: Central Records & Statistical Mgt

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 15,000	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	15,000	15,000
Annual IC Time Burden (Hours)	10,000	10,000
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

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