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Federal forms, ICRs, and supporting documents

Information Collection Request

The Domestic Violence Prevention Enhancement and Leadership through Alliances (DELTA) Program

ICR 200312-0920-002 · OMB 0920-0622 · Historical Active

Forms and Documents
DocumentTypeStatusAvailability
No forms / supporting documents in this ICR. Check IC Document Collections.
IC Document Collections
IC IDCollectionTypeStatusForm
7088 The Domestic Violence Prevention Enhancement and Leadership through Alliances (DELTA) Program Migrated
ICR Details
0920-0622 200312-0920-002
Historical Active
HHS/CDC
The Domestic Violence Prevention Enhancement and Leadership through Alliances (DELTA) Program
New collection (Request for a new OMB Control Number)   No
Regular
Approved without change 01/22/2004
Retrieve Notice of Action (NOA) 12/04/2003
CDC shall submit a separate request for approval for Stage II information collection for OMB approval. Any modifications to the evaluation instruments for years 2 and 3 shall be submitted for approval using a change worksheet (83-C).
  Inventory as of this Action Requested Previously Approved
01/31/2007 01/31/2007
532 0 0
400 0 0
0 0 0
The purpose of the proposed project is to evaluate the effectiveness of 14 Domestic Violence Prevention Enhancement and Leadership through Alliances (DELTA) grantees in disseminating and promoting primary prevention knowledge, skills, programs and activities to the community. The project will include a mail survey and a telephone interview of the DELTA grantees.
None
None
No
1
IC Title Form No. Form Name
The Domestic Violence Prevention Enhancement and Leadership through Alliances (DELTA) Program
  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 532 0 0 532 0 0
Annual Time Burden (Hours) 400 0 0 400 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.
12/04/2003