Information Collection Request
Male Survivors of Sexual Assault – Investigating Challenges around seeking help (MOSAIC)
ICR 202408-0703-001 · OMB 0703-0099 · Received in OIRA
⚠️ Notice: This information collection may be outdated. More recent filings for OMB 0703-0099 can be found here:
Forms and Documents
| Document | Type | Status | Availability |
|---|---|---|---|
 MOSAIC Recruitment Flyer 18JUN24.docx |
Supplementary Document | Uploaded 2024-08-08 | Repair queued |
| MOSAIC Recruitment Flyer (includes veterans) 18JUN24.docx |
Supplementary Document | Uploaded 2024-08-08 | Repair queued |
| MOSAIC Interview Scheduling Phone Template 13JUN24.docx |
Supplementary Document | Uploaded 2024-08-08 | Repair queued |
| MOSAIC DMDC email template.docx |
Supplementary Document | Uploaded 2024-08-08 | Repair queued |
| 0703-MSIC_SSB_7.15.2024.docx |
Supporting Statement B | Uploaded 2024-08-08 | Repair queued |
| 0703-MSIC_SSA_8.5.2024.docx |
Supporting Statement A | Uploaded 2024-08-08 | Repair queued |
IC Document Collections
| IC ID | Collection | Type | Status | Form |
|---|---|---|---|---|
| 269980 |  MOSAIC Study Interviews |
Other-Interview Guide | New | |
| 269979 | MOSAIC Study Sign Up and Informed Consent |
Other-Web Form | New |
ICR Details
| Status | Received in OIRA |
|---|---|
| Agency/Subagency | DOD/NAVY |
| OMB Control No | 0703-0099 |
| Type of Information Collection | New collection (Request for a new OMB Control Number) |
| Agency Tracking No | 0703-MSIC |
| Date Submitted to OIRA | 1969-12-31 |
| Requested Expiration Date | 1969-12-31 |