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Acceptability Survey by Site -CSU
Development and Testing of an HIV Prevention Intervention Targeting Black Bisexually-Active Men
OMB: 0920-0863
IC ID: 193027
OMB.report
HHS/CDC
OMB 0920-0863
ICR 201005-0920-005
IC 193027
( )
Documents and Forms
Document Name
Document Type
10BA_Att 3D_Acceptability Assessment.doc
Other-WORD
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Acceptability Survey by Site -CSU
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
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Other-WORD
10BA_Att 3D_Acceptability Assessment.doc
Yes
Yes
Fillable Printable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Illness Prevention
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
260
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
260
0
260
0
0
0
Annual IC Time Burden (Hours)
43
0
43
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
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.