Information Collection Request

School Associated Violent Deaths Surveillance System

ICR 201601-0920-004 · OMB 0920-0604 · Historical Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
30dy160604.docx Supplementary Document Uploaded 2016-01-12 Available
Att N_NCIPC Research Determination Form.pdf Supplementary Document Uploaded 2016-01-12 Available
Att K_Summary of Proposed Changes to Interview Tools.docx Supplementary Document Uploaded 2016-01-12 Available
Att C_CDC IRB Approval.doc Supplementary Document Uploaded 2016-01-05 Available
SSB_0604_SAVD_110215.docx Supporting Statement B Uploaded 2016-01-12 Available
Att J_Parental Consent Form.doc Supplementary Document Uploaded 2016-01-12 Available
Att M_Crosswalk for SAVD Survey Tools School Official.xlsx Supplementary Document Uploaded 2016-01-12 Available
Att L_Crosswalk for SAVD Survey Tools Law Enforcement.xlsx Supplementary Document Uploaded 2016-01-12 Available
Att H_Assurance of Confidentiality - CDC Approval for 308d Protection.doc Supplementary Document Uploaded 2016-01-12 Available
Att G_List of Selected Publications.doc Supplementary Document Uploaded 2016-01-12 Available
Att B_60dy Publi-0604 SAVD.pdf Supplementary Document Uploaded 2016-01-05 Available
Att A Authorizing Legislation.doc Supplementary Document Uploaded 2016-01-05 Available
SSA_0604_SAVD 120315.docx Supporting Statement A Uploaded 2016-01-12 Available

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
7069 Att E_School Officials (Interviews) Other-CATI Modified
191865 Att D_ Law Enforcement Officials (Interview) Other-CATI Modified

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
05/31/2019 36 Months From Approved 05/31/2016
70 0 70
76 0 70
0 0 0





Reginfo record details
2
table that charts list of burden
IC Title Form No. Form Name
Att D_ Law Enforcement Officials (Interview)
Att E_School Officials (Interviews)

table that charts list of burden
  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 70 70 0 0 0 0
Annual Time Burden (Hours) 76 70 0 6 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No