Noa

NOTICE OF OFFICE OF MANAGEMENT AND BUDGET ACTION
Date

02/06/2020

Department of Health and Human Services
Centers for Disease Control and Prevention
FOR CERTIFYING OFFICIAL:

Edwin Simcox

FOR CLEARANCE OFFICER:

Debbie Kramer

In accordance with the Paperwork Reduction Act, OMB has taken action on your request received
02/06/2020
ACTION REQUESTED: Generic IC
Strengthening hospital-based youth violence prevention
IC TITLE:
ICR REFERENCE NUMBER:

201912-0920-003

AGENCY ICR TRACKING NUMBER:
TITLE:

0920-1154

CDC/ATSDR Formative Research and Tool Development

LIST OF INFORMATION COLLECTIONS: See next page
OMB ACTION: Approved with change
OMB CONTROL NUMBER:

0920-1154

The agency is required to display the OMB Control Number and inform respondents of its legal significance in
accordance with 5 CFR 1320.5(b).
EXPIRATION DATE: 01/31/2023

BURDEN:

DISCONTINUE DATE:

RESPONSES

HOURS

COSTS

Previous

60,000

56,250

1,125,000

New

75,000

60,000

1,500,000

0

0

0

15,000

3,750

375,000

Change due to Agency Adjustment

0

0

0

Change due to PRA Violation

0

0

0

Difference
Change due to New Statute
Change due to Agency Discretion

TERMS OF CLEARANCE:

Terms of the Generic ICR remain in effect.

OMB Authorizing Official:

Dominic J. Mancini
Deputy and Acting Administrator,
Office Of Information And Regulatory Affairs

IC Title

Form No.

List of ICs
Form Name

CFR Citation

Strengthening hospital- 0920-1154
Interview Guide
based youth violence
prevention
Total Hours Actually Used for Information Collections Under Currently Approved ICR:

Hrs/$/Resp
45 / 0 / 45
45