Information Collection

Community-Based Organization HIV Prevention Survey

IC 243303 under ICR 202008-0920-007 · OMB 0920-1321.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-1321 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 0920-20HR Community-Based Organization HIV Prevention Survey	Form and Instruction
0920-20HR CBO HIV Prevention Survey Att 5a_Survey Instrument.docx	Form and Instruction
0920-20HR CBO HIV Prevention Survey Att 5a_Survey Instrument.docx	Form and Instruction
Att 5b_Survey Instrument.pdf CBO HIV Prevention Survey Screenshots	IC Document
Att 5b_Survey Instrument.pdf CBO HIV Prevention Survey Screenshots	IC Document

IC Title:

Community-Based Organization HIV Prevention Survey

Agency IC Tracking Number:

0920-20HR

Is this a Common Form? No

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
Form and Instruction	0920-20HR	CBO HIV Prevention Survey	Att 5a_Survey Instrument.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 330

Number of Respondents for Small Entity: 30

Affected Public: Private Sector

Private Sector: Businesses or other for-profits, Not-for-profit institutions

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	330	330
Annual IC Time Burden (Hours)	165	165
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
CBO HIV Prevention Survey Screenshots	Att 5b_Survey Instrument.pdf	08/25/2020

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