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Agenda
Reg Review
ICR
View Information Collection (IC)
View Information Collection (IC)
IC Title:
Veto Violence Evaluation Y2
Agency IC Tracking Number:
0920-1050-20EI
IC Status:
New
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-WORD
Att 1_Participant Letter.docx
Yes
No
Printable Only
Form
0920-1050
Violence Prevention in Practice
Att 2a_ Violence Prevention in Practice Survey.pdf
Yes
Yes
Fillable Fileable
Other-WORD
Att1a_ Welcome Email.docx
Yes
No
Printable Only
Form and Instruction
0920-1050
Connection Selector Survey
Att2_Connections Selector Survey.pdf
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Public Health Monitoring
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
580
Number of Respondents for Small Entity:
0
Affected Public:
State, Local, and Tribal Governments
Percentage of Respondents Reporting Electronically:
100 %
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
580
0
580
0
0
0
Annual IC Time Burden (Hours)
628
0
628
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
Att 3 Connection Selector Survey Screenshot
Att 3 _Connection Selector Survey screenshot.png
01/15/2020
Att 3a_Violence Preventin in Practice (Screenshot)
Att 3a_Violence Prevention in Practice Screenshot.png
01/15/2020
Att 4_PII email
Att 4_ PII email.pdf
01/15/2020
0920-1050_Request for Approval
0920-1050_OMB request_VV YR2_VPP and Connections Selector.docx
01/15/2020
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.