Information Collection

Prevention Survey

IC 247512 under ICR 202412-0704-010 · OMB 0704-0610.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Prevention Survey.pdf	Other-Survey
Prevention Survey_Final.docx	Other-Survey

IC Title:

Prevention Survey

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

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
Other-Survey					No		Paper Only

Line of Business: Defense and National Security

Subfunction: Operational Defense

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 600

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	600	-800	1,400
Annual IC Time Burden (Hours)	100	-133	233
Annual IC Cost Burden (Dollars)	1,692	-2,256	3,948

Documents for IC

table that charts IC Documents
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.

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