OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

National Intimate Partner and Sexual Violence SCREEN - General Population

IC 213547 under ICR 201903-0920-007 · OMB 0920-0822.

Documents and Forms
Document Name
Document Type
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
IC Document
IC Document
IC Document
IC Document
IC Document
IC Document
Information Collection (IC) Details

View Information Collection (IC)

National Intimate Partner and Sexual Violence SCREEN - General Population 0920-0822-19AHR
 
No Modified
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction 0920-0822 National Intimate Partner and Sexual Violence Survey (NISVS) Screen/Survey - English AttE_NISVS_Survey_English_clea.docx NA No   Fillable Fileable
Form and Instruction 0920-0822 National Intimate Partner and Sexual Violence Survey (NISVS) Screen/Survey - Spanish AttH_NISVS_Survey_Spanish_clean.docx NA No   Fillable Fileable
Form and Instruction 0920-0822 CATI Cognitive Testing Instrument, Round 1 Att C. NISVS CATI Cognitive Testing Instrument.docx Yes Yes Fillable Fileable
Form and Instruction 0920-0822 NISVS Redesign Paper Instrument Att D. NISVS Paper Cognitive Testing Instrument.docx No   Paper Only
Form and Instruction 0920-0822 Web Instrument for Cognitive Testing, Round 1 Att E. NISVS Web-Based Cognitive Testing Instrument.docx Yes Yes Fillable Fileable
Form and Instruction 0920-0822 Web-Based Recruitment Screener Att H. Recruiting Screener.docx No   Paper Only
Form and Instruction 0920-0822 NISVS Redesign CATI Cognitive Protocol -- Round 1 Att J. CATI Instrument Cog Testing Protocol.docx No   Fillable Fileable
Form and Instruction 0920-0822 NISVS Redesign Paper Protocol -- Round 1 Att K. Paper Instrument Cog Testing Protocol.docx No   Paper Only

Health Public Health Monitoring

Epidemiologic Studies and Surveillance of Disease Problems  57 FR 62812

204,000 0
   
Individuals or Households
 
   0 %

  Requested 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 204,000 0 0 0 0 204,000
Annual IC Time Burden (Hours) 10,200 0 0 0 0 10,200
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Att A_ Program Changes and Adjustments Att A. Description of Program Changes and Adjustments.docx 04/04/2019
Att B_Crosswalk of NISVS Instrument Revisions Att B. Crosswalk of NISVS Instrument Revisions for OMB.docx 04/04/2019
Att F_NISVS Redesign Cognitive Testing Plan Att F. Cognitive Testing Plan.docx 04/04/2019
Att G_Recruitment Ad Att F. Cognitive Testing Plan.docx 04/04/2019
Att I_Consent Form Att I. Cog Testing Informed Consent.docx 04/04/2019
Change Request Justification and Overview NISVS Non-substantial change request 3.18.19.docx 04/04/2019
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.