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Att. 3a_Screenshots of Metrics Database
Evaluation of Enhancing HIV Prevention Communication and Mobilization Efforts through Strategic Partnerships
OMB: 0920-1161
IC ID: 222048
OMB.report
HHS/CDC
OMB 0920-1161
ICR 202012-0920-011
IC 222048
( )
Documents and Forms
Document Name
Document Type
Att3a_Screenshots of Metrics Database.docx
Other-Screenshots
Att3b_Metrics Data Dictionary.docx
Att. 3b_ Metrics Data Dictionary
IC Document
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Att. 3a_Screenshots of Metrics Database
Agency IC Tracking Number:
16LL
Is this a Common Form?
No
IC Status:
Modified
Obligation to Respond:
Required to Obtain or Retain Benefits
CFR Citation:
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Other-Screenshots
Att3a_Screenshots of Metrics Database.docx
Yes
Yes
Printable Only
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Illness Prevention
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
44
Number of Respondents for Small Entity:
0
Affected Public:
Private Sector
Private Sector:
Not-for-profit institutions
Percentage of Respondents Reporting Electronically:
100 %
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
176
0
176
0
0
0
Annual IC Time Burden (Hours)
3,168
0
3,168
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
Att. 3b_ Metrics Data Dictionary
Att3b_Metrics Data Dictionary.docx
02/22/2021
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.