Information Collection

VetoViolence Usability Testing

IC 221710 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⚠️ Notice: This information collection may be referencing outdated material.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

Document Name Document Type
VetoViolence Usability Testing Form
Survey Attachment 3-Survey.docx Form
GenIC Request_ VetoViolence Usability Testing_052016.docx Request for Approval IC Document
Attachment 1- Recruitment Letter.docx Recruitment Letter IC Document
Attachment 2- Welcome Message.docx Welcome Message IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	VetoViolence Usability Testing	Agency IC Tracking Number:	16ANY

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	none	Survey	Attachment 3-Survey.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 60	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	60	60
Annual IC Time Burden (Hours)	60	60
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Request for Approval	GenIC Request_ VetoViolence Usability Testing_052016.docx	05/25/2016
Recruitment Letter	Attachment 1- Recruitment Letter.docx	05/25/2016
Welcome Message	Attachment 2- Welcome Message.docx	05/25/2016

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