Division of Violence Prevention grantee individual interviews regarding VetoViolence.cdc.gov

Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-1009 can be found here:

Documents and Forms

Document Name Document Type
Form 0920-1009 Division of Violence Prevention grantee individual interviews regarding VetoViolence.cdc.gov Form and Instruction
0920-1009 Instrument - VetoViolAss Instrument - VetoViolAss.docx Form and Instruction
1009_GenIC_Request_VETOViolence_121515.docx 1009_GenIC_Request_VETOViolence_121515 IC Document

Information Collection (IC) Details

IC Title:	Division of Violence Prevention grantee individual interviews regarding VetoViolence.cdc.gov	Agency IC Tracking Number:	16HO

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
Form and Instruction	0920-1009	Instrument - VetoViolAss	Instrument - VetoViolAss.docx		No		Fillable Printable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 44	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	44	44
Annual IC Time Burden (Hours)	44	44
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
1009_GenIC_Request_VETOViolence_121515	1009_GenIC_Request_VETOViolence_121515.docx	12/21/2015

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