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Federal forms, ICRs, and supporting documents

Information Collection Request

Inventory of Services and Funding Sources for Programs Designed to Prevent Violence Against Women

ICR 199506-0920-012 · OMB 0920-0375 · Historical Active

Forms and Documents
DocumentTypeStatusAvailability
No forms / supporting documents in this ICR. Check IC Document Collections.
IC Document Collections
IC IDCollectionTypeStatusForm
111112 Inventory of Services and Funding Sources for Programs Designed to Prevent Violence Against Women Migrated
ICR Details
0920-0375 199506-0920-012
Historical Active
HHS/CDC
Inventory of Services and Funding Sources for Programs Designed to Prevent Violence Against Women
New collection (Request for a new OMB Control Number)   No
Regular
Approved without change 09/29/1995
Retrieve Notice of Action (NOA) 06/30/1995
This information collection, per the revised instruments attached dated 9/28/95 and the OMB memo dated 9/28/95, is approved through 6/96 under the following terms of clearance: 1. The agency shall combine the surveys to state coalitions on domestic violence and on sexual assault into one instrument. The agency shall also combine the surveys to state agencies concern- ing funding for domestic violence and sexual assault into one instrument. This reformatting to reduce burden will be conducted in coordination with OMB, as agreed upon by the agency. 2. The agency shall pre-test the instruments prior to a full survey, and provide any revisions as an addendum to this package. 3. The agency shall ask the respondents to submit the survey instruments through the mail, not respond over the telephone. 4. The agency shall report to OMB, no later than 7/96, the results of the survey with regard to the extent and type of programs conducted at the state and local level, and on the plans and strategy for an electronic communications network for domestic violence and sexual assault programs. 5. The agency shall also develop cover letters for the survey packages in coordination with OMB, as agreed upon by the agency.
  Inventory as of this Action Requested Previously Approved
06/30/1996 06/30/1996
300 0 0
375 0 0
0 0 0
CDC proposes conducting surveys of Federal and state agencies that fund programs in domestic violence prevention, and the state coalitions on domestic violence to determine what types of programs are being conducted at the state and local levels and the funding sources for such programs.
None
None
No
1
IC Title Form No. Form Name
Inventory of Services and Funding Sources for Programs Designed to Prevent Violence Against Women
  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 300 0 0 300 0 0
Annual Time Burden (Hours) 375 0 0 375 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
No
$0
No
No
Uncollected
Uncollected
Uncollected
Uncollected
  No
On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
 
 
 
 
 
 
 
    (i) Why the information is being collected;
    (ii) Use of information;
    (iii) Burden estimate;
    (iv) Nature of response (voluntary, required for a benefit, or mandatory);
    (v) Nature and extent of confidentiality; and
    (vi) Need to display currently valid OMB control number;
 
 
 
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
06/30/1995