Information Collection

(genIC) Feedback Survey for Community Counts Data Viz Tool

IC 243553 under ICR 201912-0920-003 · OMB 0920-1154.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-1154 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Att1_(genIC) Screenshots of CC Data Viz Feedback Survey 9 3 2020.docx	Other-Screenshots
(genIC)_Request for Approval CC Data Viz 9 3 2020 (1).docx Request for Approval	IC Document
(genIC) Community Counts Data Viz SSA 9 3 2020.docx SSA	IC Document
(genIC) Community Counts Data Viz SSB 9 3 2020.docx SSB	IC Document
genIC_IRB Determination CC Data Viz 9 3 2020 (1).pdf IRB Determination	IC Document

IC Title:

(genIC) Feedback Survey for Community Counts Data Viz Tool

Agency IC Tracking Number:

0920-1154-20RS

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Screenshots			Att1_(genIC) Screenshots of CC Data Viz Feedback Survey 9 3 2020.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 300

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	300	300
Annual IC Time Burden (Hours)	15	15
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Request for Approval	(genIC)_Request for Approval CC Data Viz 9 3 2020 (1).docx	09/17/2020
SSA	(genIC) Community Counts Data Viz SSA 9 3 2020.docx	09/17/2020
SSB	(genIC) Community Counts Data Viz SSB 9 3 2020.docx	09/17/2020
IRB Determination	genIC_IRB Determination CC Data Viz 9 3 2020 (1).pdf	09/17/2020

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