Information Collection

[NCBDDD](genIC) Feedback Survey for Community Counts Data Viz Tool

IC 270185 under ICR 202507-0920-010 · OMB 0920-1154.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-1154 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 0920-1154 Feedback Survey for Community Counts Data Viz Tool [NCBDDD](genIC) Feedback Survey for Community Counts Data Viz Tool	Form and Instruction
0920-1154 Feedback Survey for Community Counts Data Viz Tool Att1_(genIC) Screenshots of CC Data Viz Feedback Survey_08092024.docx	Form and Instruction
(genIC)_Request for Approval CC Data Viz_08092024.docx Request for Approval genIC "Feedback Survey for Community Counts Data Viz Tool" (24IE)	IC Document
(genIC) Community Counts Data Viz SSA_08092024.docx genIC SSA (24IE)	IC Document
(genIC) Community Counts Data Viz SSB_08092024.docx genIC SSB (24IE)	IC Document
XC Regulatory review.docx XC Regulatory Review (24IE)	IC Document
genIC_IRB Determination CC Data Viz_08122024.pdf IRB Determination (24IE)	IC Document

IC Title:

[NCBDDD](genIC) Feedback Survey for Community Counts Data Viz Tool

Agency IC Tracking Number:

0920-1154-24IE

IC Status: Unchanged

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	0920-1154			: https://www.cdc.gov/hemophilia-community-counts/php/training/community-counts-data-visualization-tool-feedback-survey.html	Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 100

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Requested	Previously Approved
Annual Number of Responses for this IC	100	100
Annual IC Time Burden (Hours)	5	5
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Request for Approval genIC "Feedback Survey for Community Counts Data Viz Tool" (24IE)		08/16/2024
genIC SSA (24IE)		08/16/2024
genIC SSB (24IE)		08/16/2024
XC Regulatory Review (24IE)		08/16/2024
IRB Determination (24IE)		08/16/2024

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].