Information Collection

Systematic Identification and Assessment of Sexual Violence Prevention Strategies

IC 221571 under ICR 201412-0920-011 · OMB 0920-0879.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0879 can be found here:

Documents and Forms

Document Name Document Type
ATT. E Instrument Word Version.docx Other-word
Sexual Violence Prevention Strategy Description ATT. F Instrument Web Version.pdf Form
SSA-SVEVAL-SSA.docx SupSta A IC Document
SSA-SVEVAL-SSB.docx SupSta B IC Document
ATT. A RPE Awardee and Sub-awardee Counts.pdf Att A. RPE Awardee and Sub-awardee Counts IC Document
ATT. B VAWA Reauthorization Legislation.pdf Att B. VAWA Legislation IC Document
ATT. C Public Health Service Act 42 USC 280b-1b.pdf Att C. Public Health Service Act 42 USC 280b-1b IC Document
ATT. G Call for Nominations.docx Att G: Call for Nominations IC Document
ATT. H Reminder.docx Att H: REMINDER IC Document
ATT. I Follow-up Email.docx Att I: FOLLOW-UP EMAIL IC Document
ATT. D Rape Prevention and Education Program Factsheet.docx Att D: Rape Prevention and Education Program Fact Sheet IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Systematic Identification and Assessment of Sexual Violence Prevention Strategies	Agency IC Tracking Number:	16ALN

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
Other-word			ATT. E Instrument Word Version.docx		Yes	Yes	Fillable Fileable
Form	none	Sexual Violence Prevention Strategy Description	ATT. F Instrument Web Version.pdf		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 525	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	525	525
Annual IC Time Burden (Hours)	424	424
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
SupSta A	SSA-SVEVAL-SSA.docx	05/20/2016
SupSta B	SSA-SVEVAL-SSB.docx	05/20/2016
Att A. RPE Awardee and Sub-awardee Counts	ATT. A RPE Awardee and Sub-awardee Counts.pdf	05/20/2016
Att B. VAWA Legislation	ATT. B VAWA Reauthorization Legislation.pdf	05/20/2016
Att C. Public Health Service Act 42 USC 280b-1b	ATT. C Public Health Service Act 42 USC 280b-1b.pdf	05/20/2016
Att G: Call for Nominations	ATT. G Call for Nominations.docx	05/20/2016
Att H: REMINDER	ATT. H Reminder.docx	05/20/2016
Att I: FOLLOW-UP EMAIL	ATT. I Follow-up Email.docx	05/20/2016
Att D: Rape Prevention and Education Program Fact Sheet	ATT. D Rape Prevention and Education Program Factsheet.docx	05/20/2016

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