Information Collection

GenIC Division of Violoence Prevention Webinar Participant Feedback

IC 222774 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⚠️ Notice: This information collection may be referencing outdated material.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
Att 1_Webinar Feedback Form.docx	Other-WORD
Att 2_Invitation Email.docx Att 2_ Invitation Email	IC Document
Att 3_Reminder Email.docx Att 3_Reminder Email	IC Document
Att 4_Listerv Announcement.docx Att 4_Listserv Announcement Email	IC Document
Service Orien GenIC Request_DVP Webinar Participant Feedback_72616KA.docx Request for Approval	IC Document

IC Title:

GenIC Division of Violoence Prevention Webinar Participant Feedback

Agency IC Tracking Number:

16AWI

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
Other-WORD			Att 1_Webinar Feedback Form.docx		Yes	Yes	Fillable Printable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 800

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	800	800
Annual IC Time Burden (Hours)	40	40
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Att 2_ Invitation Email	Att 2_Invitation Email.docx	08/01/2016
Att 3_Reminder Email	Att 3_Reminder Email.docx	08/01/2016
Att 4_Listserv Announcement Email	Att 4_Listerv Announcement.docx	08/01/2016
Request for Approval	Service Orien GenIC Request_DVP Webinar Participant Feedback_72616KA.docx	08/01/2016

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