View Information Collection Request (ICR) Package
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Certification
View Information Collection (IC) List
View Supporting Statement and Other Documents
Please note that the OMB number and expiration date may not have been determined when this Information Collection Request and associated Information Collection forms were submitted to OMB. The approved OMB number and expiration date may be found by clicking on the Notice of Action link below.
View Generic ICR - OIRA Conclusion
OMB Control No:
0920-0920
ICR Reference No:
201403-0920-004
Status:
Historical Active
Previous ICR Reference No:
201209-0920-006
Agency/Subagency:
HHS/CDC
Agency Tracking No:
21568
Title:
Data Collection Through Web Based Surveys for Evaluating Act Against AIDS Social Marketing Campaign Phases Targeting Consumers
Type of Information Collection:
No material or nonsubstantive change to a currently approved collection
Common Form ICR:
No
Type of Review Request:
Regular
OIRA Conclusion Action:
Approved with change
Conclusion Date:
03/14/2014
Retrieve Notice of Action (NOA)
Date Received in OIRA:
03/13/2014
Terms of Clearance:
Previous terms continue: For each information collection, a GenIC information collection request will be prepared and submitted to OMB for review and approval. Any changes to the ICR will also be submitted to OMB for review and approval.
Inventory as of this Action
Requested
Previously Approved
Expiration Date
02/28/2015
02/28/2015
02/28/2015
Responses
72,000
0
72,000
Time Burden (Hours)
8,001
0
8,001
Cost Burden (Dollars)
0
0
0
Abstract:
CDC requests to make a change in frequency of data collection from quarterly to varied.
Authorizing Statute(s):
US Code:
42 USC 301.241
Name of Law: Public Health Service Act
Citations for New Statutory Requirements:
None
Associated Rulemaking Information
RIN:
Stage of Rulemaking:
Federal Register Citation:
Date:
Not associated with rulemaking
Federal Register Notices & Comments
Did the Agency receive public comments on this ICR?
No
Number of Information Collection (IC) in this ICR:
4
IC Title
Form No.
Form Name
African American Women's Perceptions of a Social Marketing Campaign to Promote HIV Testing
none, none
Screener
,
Survey
Evaluating Social Marketing Campaigns Targeting Gay/Bisexual Men
HIV Prevention and Testing Messages for Act Against AIDS Social Marketing Campaigns Targeting Gay/Bisexual Men
none, none
Att 2 - Survey Instrument
,
Att 3 - Screener
Message Testing for the AAA Campaign - Hispanics/Latinos
0920-0920, 0920-0920, 0920-0920, 0920-0920
Message Testing for the AAA Campaign - Hispanics/Latinos
,
Attachment 2_Web-based Screener_Eng
,
Attachment 1 Message Testing for the AAA Campaign - HispanicsLatinos
,
Attachment 2A_Web-based Screener_Spn
ICR Summary of Burden
Total Approved
Previously Approved
Change Due to New Statute
Change Due to Agency Discretion
Change Due to Adjustment in Estimate
Change Due to Potential Violation of the PRA
Annual Number of Responses
72,000
72,000
0
0
0
0
Annual Time Burden (Hours)
8,001
8,001
0
0
0
0
Annual Cost Burden (Dollars)
0
0
0
0
0
0
Burden increases because of Program Change due to Agency Discretion:
No
Burden Increase Due to:
Burden decreases because of Program Change due to Agency Discretion:
No
Burden Reduction Due to:
Short Statement:
Annual Cost to Federal Government:
$247,586
Does this IC contain surveys, censuses, or employ statistical methods?
Yes
Part B of Supporting Statement
Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002?
No
Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]?
No
Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]?
No
Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)?
No
Is this ICR related to the Pandemic Response?
Uncollected
Agency Contact:
Catina Conner 4046394775
Common Form ICR:
No
On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
(a) It is necessary for the proper performance of agency functions;
(b) It avoids unnecessary duplication;
(c) It reduces burden on small entities;
(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;
(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;
(f) It indicates the retention periods for recordkeeping requirements;
(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:
(i) Why the information is being collected;
(ii) Use of information;
(iii) Burden estimate;
(iv) Nature of response (voluntary, required for a benefit, or mandatory);
(v) Nature and extent of confidentiality; and
(vi) Need to display currently valid OMB control number;
(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.
(i) It uses effective and efficient statistical survey methodology (if applicable); and
(j) It makes appropriate use of information technology.
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
Certification Date:
03/13/2014
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