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Att E_School Officials (Interviews)
School Associated Violent Deaths Surveillance System
OMB: 0920-0604
IC ID: 7069
OMB.report
HHS/CDC
OMB 0920-0604
ICR 201601-0920-004
IC 7069
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0604 can be found here:
2019-05-02 - Revision of a currently approved collection
Documents and Forms
Document Name
Document Type
Att E_School Official (Interview).docx
Other-CATI
Att I_Telephone Consent Script.doc
Att I_Telephone Consent Script (Officials)
IC Document
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Att E_School Officials (Interviews)
Agency IC Tracking Number:
0604
Is this a Common Form?
No
IC Status:
Modified
Obligation to Respond:
Voluntary
CFR Citation:
42 CFR 242
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Other-CATI
Att E_School Official (Interview).docx
Yes
Yes
Fillable Printable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Consumer Health and Safety
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
35
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
100 %
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
35
0
0
0
0
35
Annual IC Time Burden (Hours)
38
0
3
0
0
35
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
Att I_Telephone Consent Script (Officials)
Att I_Telephone Consent Script.doc
01/12/2016
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.