Information Collection

Evaluation of the Safe Dates Project - Effectivness Follow-up Survey

IC 183247 under ICR 200801-0920-002 · OMB 0920-0783.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0783 can be found here:

Documents and Forms

Document Name Document Type
Attachment K_Follow-up Script_10-12-07.doc Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Evaluation of the Safe Dates Project - Effectivness Follow-up Survey	Agency IC Tracking Number:

Is this a Common Form? Yes		IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Instruction			Attachment K_Follow-up Script_10-12-07.doc		Yes	No	Fillable Printable

Line of Business: Health

Subfunction: Illness Prevention

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 8,126	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	8,126	8,126
Annual IC Time Burden (Hours)	4,740	4,740
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

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.