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Core VIPP Non-Funded SHD: SOTS Financial Module
Evaluation of Core Violence and Injury Prevention Program
OMB: 0920-0916
IC ID: 200347
OMB.report
HHS/CDC
OMB 0920-0916
ICR 201112-0920-002
IC 200347
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0916 can be found here:
2014-01-22 - Revision of a currently approved collection
2013-02-14 - No material or nonsubstantive change to a currently approved collection
Documents and Forms
Document Name
Document Type
Form 4
Core VIPP Non-Funded SHD: SOTS Financial Module
Form and Instruction
4 Core VIPP Non-Funded SHD: SOTS Financial Module
Attachment E-2 - WORD.docx
Form and Instruction
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Core VIPP Non-Funded SHD: SOTS Financial Module
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
New
Obligation to Respond:
Mandatory
CFR Citation:
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form and Instruction
4
Core VIPP Non-Funded SHD: SOTS Financial Module
Attachment E-2 - WORD.docx
Yes
Yes
Fillable Printable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Health Care Services
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
22
Number of Respondents for Small Entity:
0
Affected Public:
State, Local, and Tribal Governments
Percentage of Respondents Reporting Electronically:
50 %
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
22
0
22
0
0
0
Annual IC Time Burden (Hours)
22
0
22
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.