Information Collection

[ATSDR] Social Vulnerability Index (SVI) User Survey

IC 273680 under ICR 202411-0923-001 · OMB 0923-0047.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 0923-0047 SVI User Survey [ATSDR] Social Vulnerability Index (SVI) User Survey	Form and Instruction
0923-0047 SVI User Survey SVI User Survey 2024_Final Draft.docx	Form and Instruction
SVI User Survey_Email Draft.docx SVI User Survey Email Invitation	IC Document
Request - SVI User Survey.docx 0923-0047 GenIC Request Template	IC Document

IC Title:

Agency IC Tracking Number:

0923-0047-25BY

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	0923-0047			N/A	Yes	Yes	Fillable Fileable

Line of Business: Disaster Management

Subfunction: Disaster Preparedness and Planning

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 250

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

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	250	250
Annual IC Time Burden (Hours)	63	63
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
SVI User Survey Email Invitation		01/15/2025
0923-0047 GenIC Request Template		01/15/2025

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

Something went wrong when downloading this file. If you have any questions, please send an email to [email protected].