CDC's Social Vulnerability Index Webpage Survey

Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0923-0047 can be found here:

Documents and Forms

Document Name Document Type
CDC's Social Vulnerability Index Webpage Survey Form and Instruction
Survey for CDC's Social Vulnerability Index (SVI) Websit Attachment C - CDC SVI Survey Screenshot.docx Form and Instruction
Attachment A - Email Invitation for CDC SVI Survey.docx Survey Invitation - Email IC Document
Social Vulnerability Index Webpage Survey GenIC Request Form.pdf GenIC Request IC Document

Information Collection (IC) Details

IC Title:	CDC's Social Vulnerability Index Webpage Survey	Agency IC Tracking Number:	0923-0047-17AHV

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	NA	Survey for CDC's Social Vulnerability Index (SVI) Website - Screenshot	Attachment C - CDC SVI Survey Screenshot.docx	NA	Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 30	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	30	30
Annual IC Time Burden (Hours)	8	8
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Survey Invitation - Email	Attachment A - Email Invitation for CDC SVI Survey.docx	04/28/2017
GenIC Request	Social Vulnerability Index Webpage Survey GenIC Request Form.pdf	04/28/2017

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