OMB.report

Federal forms, ICRs, and supporting documents

Information Collection Request

Pilot Implementation of the Violence Against Children and Youth Survey (VACS) in the US

ICR 202012-0920-010 · OMB 0920-1356 · Received in OIRA

Forms and Documents
DocumentTypeStatusAvailability
Youth participant questionnaire Form New Repair queued
Youth participant consent Form and Instruction New Repair queued
Head of household questionnaire Form New Available
Head of household Consent Form and Instruction New Repair queued
Screener Form and Instruction New Repair queued
Invitation to participate Form and Instruction New Repair queued
AttachmentG_IRB Approval.pdf Supplementary Document Uploaded 2020-12-15 Repair queued
AttachmentC_Privacy Impact Assessment (PIA).pdf Supplementary Document Uploaded 2020-12-15 Repair queued
AttachmentB_ 60 Dy FRN VACS.pdf Supplementary Document Uploaded 2020-12-15 Repair queued
AttachmentA_ Authorizing Legislation.docx Supplementary Document Uploaded 2020-12-15 Repair queued
SSB__VACS_12.14.2020.docx Supporting Statement B Uploaded 2020-12-15 Repair queued
SSA _ VACS_12.14.2020.docx Supporting Statement A Uploaded 2020-12-15 Repair queued
IC Document Collections
IC IDCollectionTypeStatusForm
244953 Youth participant questionnaire Form New
244952 Youth participant consent Form and Instruction New
244951 Head of household questionnaire Form New
244949 Head of household Consent Form and Instruction New
244941 Screener Form and Instruction New
244940 Invitation to participate Form and Instruction New
ICR Details
202012-0920-010
Received in OIRA
HHS/CDC 0920-20QO
Pilot Implementation of the Violence Against Children and Youth Survey (VACS) in the US
New collection (Request for a new OMB Control Number)   No
Regular 01/11/2021
  Requested Previously Approved
36 Months From Approved
8,272 0
834 0
23,761 0
This request is to conduct the Pilot Implementation of the Violence Against Children and Youth Survey (VACS) in the United States, which CDC has conducted in 24 countries globally and has adapted for a domestic context. More specifically, this request details the adaptations to the survey and methods for piloting the survey in one urban and one rural area of the United States.
US Code: 42 USC 241 Name of Law: PHSA
  
None
Not associated with rulemaking
  85 FR 45432 07/28/2020
86 FR 1111 01/07/2021
No
  Total Request 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 8,272 0 0 8,272 0 0
Annual Time Burden (Hours) 834 0 0 834 0 0
Annual Cost Burden (Dollars) 23,761 0 0 23,761 0 0
Yes
Miscellaneous Actions
No
This is a new ICR.
$1,960,867
Yes Part B of Supporting Statement
    No
    No
No
No
No
No
Shari Steinberg 404 639-4942 [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.
01/11/2021