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2014 National Intimate Partner and Sexual Violence Survey
The National Intimate Partner and Sexual Violence Survey (NISVS)
OMB: 0920-0822
IC ID: 213548
OMB.report
HHS/CDC
OMB 0920-0822
ICR 201410-0920-019
IC 213548
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0822 can be found here:
2023-11-09 - No material or nonsubstantive change to a currently approved collection
2023-02-16 - Revision of a currently approved collection
Documents and Forms
Document Name
Document Type
2014 National Intimate Partner and Sexual Violence Survey
Form and Instruction
2014 National Intimate Partner and Sexual Violence Scree
AttH_Instr_NISVS_Surv_SPANISH_0822.docx
Form and Instruction
2014 National Intimate Partner and Sexual Violence Scree
Att E_ Instru_NISVS_Survey_0822.docx
Form and Instruction
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
2014 National Intimate Partner and Sexual Violence Survey
Agency IC Tracking Number:
Is this a Common Form?
No
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 and Instruction
None
2014 National Intimate Partner and Sexual Violence Screen/Survey-Spanish
AttH_Instr_NISVS_Surv_SPANISH_0822.docx
None
No
Fillable Fileable
Form and Instruction
None
2014 National Intimate Partner and Sexual Violence Screen/Survey-English
Att E_ Instru_NISVS_Survey_0822.docx
None
No
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Public Health Monitoring
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
12,500
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
0 %
Approved
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
12,500
0
12,500
0
0
0
Annual IC Time Burden (Hours)
5,208
0
5,208
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
No associated records found
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.