BASE -Injury Indicator

Monitoring and Reporting for the Core State Violence and Injury Prevention Program Cooperative Agreement

OMB: 0920-1120

IC ID: 220420

Information Collection (IC) Details

View Information Collection (IC)

BASE -Injury Indicator 16BZ
 
No New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-WORD Att E_Injury Indicators.010716.xlsx Yes Yes Fillable Fileable

Health Public Health Monitoring

 

20 0
   
State, Local, and Tribal Governments
 
   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 20 0 20 0 0 0
Annual IC Time Burden (Hours) 280 0 280 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
e2_Injury Indicator Spreadsheet Instructions Att E2_Inj Ind Instructions.pdf 03/03/2016
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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