HIV Surveillance Data System Needs and IT Capability Assessment

Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery (NCHHSTP)

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-1027 can be found here:

Documents and Forms

Document Name Document Type
HIV Surveillance Data System Needs and IT Capability Assessment Form and Instruction
HIV Surveillance System and IT Capability Survey Questions_HIV Surveillance Data System Needs and IT Capability_20201216.docx Form and Instruction
Generic Clearance_HIV Surveillance Data System Needs and IT Capability Assessment.docx GENIC Template with Project Description IC Document

Information Collection (IC) Details

IC Title:	HIV Surveillance Data System Needs and IT Capability Assessment	Agency IC Tracking Number:	0920-21BP

IC Status: New

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	n/a	HIV Surveillance System and IT Capability Survey	Questions_HIV Surveillance Data System Needs and IT Capability_20201216.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 59	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	59	59
Annual IC Time Burden (Hours)	118	118
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
GENIC Template with Project Description	Generic Clearance_HIV Surveillance Data System Needs and IT Capability Assessment.docx	12/18/2020

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