Questionnaire, web (Att. K-L)

[NCIPC] The National Intimate Partner and Sexual Violence Survey (NISVS)

Documents and Forms

Document Name Document Type
Form 0920-0822 Questionnaire, web (Att. K-L) Form and Instruction
0920-0822 Att K_Web_Phone Screeners and Survey Instrument_English_ Att K_Web_Phone Screeners and Survey Instrument_English_REV1.10.23Clean.docx Form and Instruction
0920-0822 Att K_Web_Phone Screeners and Survey Instrument_English_ Att K_Web_Phone Screeners and Survey Instrument_English_REV1.10.23Clean.docx Form and Instruction
0920-0822 Att L_Web_Phone Screeners and Survey Instrument_Spanish Att L_Web_Phone Screeners and Survey Instrument_Spanish.docx Form and Instruction
0920-0822 Att L_Web_Phone Screeners and Survey Instrument_Spanish Att L_Web_Phone Screeners and Survey Instrument_Spanish.docx Form and Instruction

Information Collection (IC) Details

IC Title:	Questionnaire, web (Att. K-L)	Agency IC Tracking Number:

Is this a Common Form? Yes		IC Status: Unchanged

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	0920-0822	Att K_Web_Phone Screeners and Survey Instrument_English_REV1.10.23Clean	Att K_Web_Phone Screeners and Survey Instrument_English_REV1.10.23Clean.docx		Yes	Yes	Fillable Fileable
Form and Instruction	0920-0822	Att L_Web_Phone Screeners and Survey Instrument_Spanish	Att L_Web_Phone Screeners and Survey Instrument_Spanish.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title: Epidemiologic Studies and Surveillance of Disease Problems	FR Citation: 57 FR 62812

Number of Respondents: 26,667	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Previously Approved
Annual Number of Responses for this IC	26,667	26,667
Annual IC Time Burden (Hours)	11,111	11,111
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

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