Information Collection

Youth Violence Training and Technical Assistance Satisfaction Survey

IC 219607 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⚠️ Notice: This information collection may be referencing outdated material.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 Youth Violence Training and Technical Assistance Satisfaction Survey	Form and Instruction
0920-1009 0920-1009 16JS Youth Violence Training Survey_YV TTA Customer Satifaction 1 15 16.docx	Form and Instruction
GenIC_1009_Request_YV TTA_1 14 16.docx GenIC_1009_Request_YV TTA_1 14 16	IC Document

IC Title:

Youth Violence Training and Technical Assistance Satisfaction Survey

Agency IC Tracking Number:

16JS

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	0920-1009 16JS Youth Violence Training	Survey_YV TTA Customer Satifaction 1 15 16.docx		No		Fillable Printable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 12

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	12	12
Annual IC Time Burden (Hours)	3	3
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
GenIC_1009_Request_YV TTA_1 14 16	GenIC_1009_Request_YV TTA_1 14 16.docx	01/19/2016

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