OMB.report

Federal forms, ICRs, and supporting documents

Information Collection Request

The National Intimate Partner and Sexual Violence Survey (NISVS)

ICR 201906-0920-002 · OMB 0920-0822 · Historical Active

Forms and Documents
DocumentTypeStatusAvailability
Form 0920-0822 National Intimate Partner and Sexual Violence Survey (NISVS) - Developmental Testing Form and Instruction Modified Available
Form 0920-0822 National Intimate Partner and Sexual Violence SURVEY - General Population Form and Instruction Unchanged Available
Form 0920-0822 National Intimate Partner and Sexual Violence SCREEN - General Population Form and Instruction Unchanged Available
NISVS Non-substantial change request 3.18.19 OMB_CDC revision_Clean 6.10.19.docx Justification for No Material/Nonsubstantive Change Uploaded 2019-06-14 Repair queued
AttL_NISVS Workgroup Summary - Final.docx Supplementary Document Uploaded 2018-02-13 Available
AttK_Workgroup Participants.docx Supplementary Document Uploaded 2017-12-12 Available
AttJ2_Crosswalk of Program Changes and Adjustments.xlsx Supplementary Document Uploaded 2017-12-12 Available
AttJ1_Description of Program Changes and Adjustments-Final.docx Supplementary Document Uploaded 2018-02-13 Available
AttI_Lead Letters.docx Supplementary Document Uploaded 2017-12-12 Available
AttG_PIA_NISVS_0822.pdf Supplementary Document Uploaded 2017-12-12 Available
AttF_Security Agreement.doc Supplementary Document Uploaded 2017-12-12 Repair queued
AttD_IRBApproval.pdf Supplementary Document Uploaded 2017-12-12 Available
AttC_Outside Consultation.pdf Supplementary Document Uploaded 2017-12-12 Repair queued
AttB1_60 Day FRN 2017.pdf Supplementary Document Uploaded 2017-12-12 Repair queued
SSB_NISVS_Clean_2.5.18.docx Supporting Statement B Uploaded 2018-02-08 Available
SSA_0822_NISVS 11.27.17_clean OMB comment_Jan11 - Rev 2.8.18.docx Supporting Statement A Uploaded 2018-02-08 Repair queued
NISVS Work Group Timeline 070816 - Final OMB comments CDC 071916 clean OMB.docx Supplementary Document Uploaded 2016-07-19 Available
Timeline NISVS.docx Supplementary Document Uploaded 2015-02-06 Repair queued
AttA_AuthLeg_0822.docx Supplementary Document Uploaded 2014-10-16 Available
IC Document Collections
IC IDCollectionTypeStatusForm
230016 National Intimate Partner and Sexual Violence Survey (NISVS) - Developmental Testing Form and Instruction Modified
213548 National Intimate Partner and Sexual Violence SURVEY - General Population Form and Instruction Unchanged
213547 National Intimate Partner and Sexual Violence SCREEN - General Population Form and Instruction Unchanged
ICR Details
0920-0822 201906-0920-002
Historical Active 201712-0920-001
HHS/CDC 0920-0822-19BGX
The National Intimate Partner and Sexual Violence Survey (NISVS)
No material or nonsubstantive change to a currently approved collection   No
Regular
Approved without change 06/17/2019
Retrieve Notice of Action (NOA) 06/17/2019
Previous terms continue. CDC will brief OIRA desk officers in advance of upcoming changes and findings from cognitive testing.
  Inventory as of this Action Requested Previously Approved
02/29/2020 02/29/2020 02/29/2020
239,700 0 239,700
25,336 0 25,216
0 0 0
The National Intimate Partner and Sexual Violence Survey is an ongoing, nationally representative survey of non-institutionalized adult men and women aged 18 years or older in the United States assessing lifetime experiences to assess experiences of intimate partner violence, sexual violence and stalking among adults in the US. It measures lifetime victimization for these types of violence as well as in the previous 12 months. This Non-Substantive Change Request is submitted for the addition of three Cognitive Testing Instruments (CATI, Paper, Web-based).
US Code: 42 USC 241 Name of Law: Public Health Service Act
  
None
Not associated with rulemaking
  82 FR 43988 09/20/2017
82 FR 60998 12/26/2017
Yes
  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 239,700 239,700 0 0 0 0
Annual Time Burden (Hours) 25,336 25,216 0 120 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
Miscellaneous Actions
No
Submission of the Non-Substantive Change Request (0920-0822, NISVS) includes addition of Cognitive Testing Instruments (CATI, Paper, Web-based), and results in an increase of 120 Burden Hours.
$7,557,338
Yes Part B of Supporting Statement
    Yes
    No
No
No
No
Uncollected
Jeffrey Zirger 404 639-7118 [email protected]
  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.
06/17/2019