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⚠️ Notice: This information collection may be referencing outdated material.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

Documents and forms in this information collection
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

IC Title:

VetoViolence Usability Testing

Agency IC Tracking Number:

16ANY

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	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 %

table that charts list of burden
	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

table that charts IC Documents
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.