National Intimate Partner and Sexual Violence Screen - Military

The National Intimate Partner and Sexual Violence Survey (NISVS)

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0822 can be found here:

Documents and Forms

Document Name Document Type
National Intimate Partner and Sexual Violence Screen - Military Form and Instruction
National Intimate Partner and Sexual Violence Screen/Sur AttE_1_DLV 7b_M5d_FINAL_NISVS3_Combined_Survey_English_07-13-2016 dropped extra SO_OMB EDIT CDC 071816 clean.docx Form and Instruction

Information Collection (IC) Details

IC Title:	National Intimate Partner and Sexual Violence Screen - Military	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Removed

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	National Intimate Partner and Sexual Violence Screen/Survey (NISVS) 3.0 General Population and Military - FINAL English	AttE_1_DLV 7b_M5d_FINAL_NISVS3_Combined_Survey_English_07-13-2016 dropped extra SO_OMB EDIT CDC 071816 clean.docx	NA	No		Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title: Epidemiologic Studies and Surveillance of Disease Problems	FR Citation: 57 FR 62812

Number of Respondents: 73,800	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	-73,800	73,800
Annual IC Time Burden (Hours)	-3,690	3,690
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

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