Information Collection

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

IC 219366 under ICR 201405-0920-002 · OMB 0920-1009.

⚠️ Notice: This information collection may be referencing outdated material.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

Documents and Forms

Documents and forms in this information collection
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

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:

table that charts list of 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 %

table that charts list of burden
	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

table that charts IC Documents
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.