Development of Messages for the Let's Stop HIV Together National Campaign

Data Collection Through Web Based Surveys for Evaluating Act Against AIDS Social Marketing Campaign Phases Targeting Consumers

⚠️ Notice: This information collection may be referencing outdated material.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

Documents and Forms

Document Name Document Type
Form 0920-22HR Development of Messages for the Let's Stop HIV Together National Campaign Form and Instruction
0920-22HR Att 2 Web-based Survey Screener Att 2 Web-based Survey Screener.docx Form and Instruction
0920-22HR Att 3 Web-Based Survey Att 3 Web-Based Survey.docx Form and Instruction
Att 1 Web-Based Consent Form.docx Consent Form IC Document
Att 4 Screenshots.docx Att 4 Screenshots IC Document
Att 5 Email Reminder.docx Email Reminder IC Document
Att 6 Messages.docx Att 6 Messages IC Document
Att 7 Concepts.docx Att 7 Concepts IC Document
Supporting Statement A.docx SSA IC Document
Supporting Statement B.docx SSB IC Document

Information Collection (IC) Details

IC Title:	Development of Messages for the Let's Stop HIV Together National Campaign	Agency IC Tracking Number:	0920-22HR

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	0920-22HR	Att 2 Web-based Survey Screener	Att 2 Web-based Survey Screener.docx		Yes	Yes	Fillable Fileable
Form and Instruction	0920-22HR	Att 3 Web-Based Survey	Att 3 Web-Based Survey.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 10,500	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	10,500	10,500
Annual IC Time Burden (Hours)	2,450	2,450
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Consent Form	Att 1 Web-Based Consent Form.docx	07/26/2022
Att 4 Screenshots	Att 4 Screenshots.docx	07/26/2022
Email Reminder	Att 5 Email Reminder.docx	07/26/2022
Att 6 Messages	Att 6 Messages.docx	07/26/2022
Att 7 Concepts	Att 7 Concepts.docx	07/26/2022
SSA	Supporting Statement A.docx	07/26/2022
SSB	Supporting Statement B.docx	07/26/2022

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