View Information Collection (IC)

View Information Collection (IC)

RANDS - NISVS 0920-0222-21GE
 
New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction 0920-0222 Questionnaire 55 minute Att 2 - RANDS NSVIS Questionnaire and Intro Script-revised_55.docx Yes No Fillable Fileable
Form and Instruction 0920-0222 Questionnaire 20 minute Att 2 - RANDS NSVIS Questionnaire and Intro Script-revised_final.docx Yes No Fillable Fileable
Form and Instruction 0920-0222 Telephone screener - flyer and database Att 4ab - RANDS NISVS Telephone Screener CLEAN_final.docx Yes No Fillable Fileable
Form and Instruction 0920-0222 Respondent Data Collection Sheet Att 6- RANDS NISVS Resp Data Collect Sheet_final.docx Yes No Fillable Fileable
Form and Instruction 0920-0222 Respondent Debriefing Att 8 - RANDS NISVS Respondent Debriefing CLEAN.docx Yes No Fillable Fileable

Health Public Health Monitoring

 

6,780 0
   
Private Sector Businesses or other for-profits, Not-for-profit institutions
 
   90 %

  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 6,780 0 6,780 0 0 0
Annual IC Time Burden (Hours) 2,242 0 2,242 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Overview of Procedures Att 1 - RANDS NISVS Overview of Procedures CLEAN.docx 07/02/2021
RANDS NISVS Ads Att 3ab - RANDS NISVS Ads CLEAN.docx 07/02/2021
Informed Consent Att 5 - RANDS NISVS Informed Consent CLEAN.docx 07/02/2021
Thank You Letter Att 7 - RANDS NISVS Thank You Letter.docx 07/02/2021
NORC Protection Plan Att 9 - NORC CIPESA Protection Plan_vcb060421.docx 07/02/2021
Non-Disclosure Affidavit Att 10 - NCHS Non-Disclosure Affidavit for NORC CLEAN.docx 07/02/2021
Distress Guide Att 11 Distress guide.docx 07/02/2021
OMB 10-day Letter OMB 10-day Letter_RANDS_NISVS 6 30 21.docx 07/02/2021
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.