View Information Collection (IC)

View Information Collection (IC)

IC Title:	Florida Domestic Violence State Coalition Community Stakeholder Feedback (Virtual Town Halls and Online Survey)	Agency IC Tracking Number:	FYSB

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-Discussion and Survey Questions			Florida Domestic Violence State Coalition Community Stakeholder Feedback Questions Final Version.docx		Yes	Yes	Printable Only

Federal Enterprise Architecture Business Reference Module

Line of Business: Community and Social Services

Subfunction: Social Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 500	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	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	500	0	500	0	0	0
Annual IC Time Burden (Hours)	450	0	450	0	0	0
Annual IC Cost Burden (Dollars)	0	0	0	0	0	0

Documents for IC

Title	Document	Date Uploaded
SSA - Formative Program Support GenIC - FVPSA FL Coalition Feedback	Generics Supporting Statement A - FVPSA Florida Coalition Community Feedback - Final Version.docx	07/20/2021

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