National HIV Behavioral Surveillance System

ICR 201112-0920-012

OMB: 0920-0770

Federal Form Document

Forms and Documents
Document
Name
Status
Form and Instruction
Modified
Form and Instruction
Modified
Form and Instruction
Modified
Form and Instruction
Modified
Form and Instruction
Modified
Supplementary Document
2011-12-14
Supplementary Document
2011-12-14
Justification for No Material/Nonsubstantive Change
2011-12-14
Supplementary Document
2011-03-08
ICR Details
0920-0770 201112-0920-012
Historical Active 201103-0920-003
HHS/CDC
National HIV Behavioral Surveillance System
No material or nonsubstantive change to a currently approved collection   No
Regular
Approved without change 12/21/2011
Retrieve Notice of Action (NOA) 12/19/2011
  Inventory as of this Action Requested Previously Approved
05/31/2014 05/31/2014 05/31/2014
31,668 0 31,668
9,932 0 9,932
0 0 0

This is a change request to submit a revised questionnaire to improve understandability and responses.

US Code: 42 USC 301 Name of Law: Public Health Service Act
   US Code: 42 USC 306 Name of Law: Public Health Service Act
  
None

Not associated with rulemaking

Yes

  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 31,668 31,668 0 0 0 0
Annual Time Burden (Hours) 9,932 9,932 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No

$12,710,009
Yes Part B of Supporting Statement
Yes
No
No
No
Uncollected
Daniel Holcomb 770 488-4472 [email protected]

  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:
 
 
 
 
 
 
 
    (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;
 
 
 
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.
12/19/2011


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