OMB.report

Federal forms, ICRs, and supporting documents

Information Collection Request

The National Intimate Partner and Sexual Violence Survey (NISVS)

ICR 202105-0920-008 · OMB 0920-0822 · Received in OIRA

Forms and Documents
DocumentTypeStatusAvailability
Phase 3 - ABS inbound CATI Form and Instruction Removed Repair queued
Phase 3 - ABS phone survey Form and Instruction Modified Repair queued
Phase 3 - ABS web Survey Form and Instruction Removed Repair queued
Phase 3 - ABS Web Survey Form and Instruction Modified Repair queued
Phase 3 - ABS Paper screener - YMOF method Form and Instruction Removed Missing upstream
Phase 3 - ABS, paper screener Form Modified Repair queued
Phase 3 - ABS, web screener Form and Instruction Modified Repair queued
Phase 3 - RDD (CATI) screener Form and Instruction Removed Repair queued
Phase 2 - Cognitive testing Form and Instruction Removed Repair queued
Phase 2 - Panel, web Survey Form and Instruction Removed Repair queued
Phase 2 - ABS, in-bound CATI Form and Instruction Removed Missing upstream
Phase 2 - ABS Paper Survey Form and Instruction Removed Repair queued
Phase 2 - ABS web Survey Form and Instruction Removed Repair queued
Phase 2 - RDD (CATI) Survey Form and Instruction Removed Repair queued
Phase 2 - ABS screener, paper YMOF method Form and Instruction Removed Repair queued
Phase 2 - ABS, paper screener, Roster method Form and Instruction Removed Repair queued
Phase 2 - ABS web screener Form and Instruction Removed Repair queued
Phase 2- RDD (CATI) screener Form and Instruction Removed Repair queued
IRB Approval.pdf Supplementary Document Uploaded 2021-05-20 Repair queued
OMB Change Request for NISVS_5.4.21_FINAL (003).docx Justification for No Material/Nonsubstantive Change Uploaded 2021-05-19 Repair queued
Att O_Pilot Sample Design and Data Collection Procedures.docx Supplementary Document Uploaded 2021-05-19 Repair queued
Att N_Westat Recommendations for NISVS.docx Supplementary Document Uploaded 2021-05-19 Repair queued
Att K_Crosswalk of Survey Revisions.docx Supplementary Document Uploaded 2021-05-19 Repair queued
Att J_Screener Thank You Letter_CLEAN.docx Supplementary Document Uploaded 2021-05-19 Repair queued
Att I.5_Reminder Postcard_CLEAN.docx Supplementary Document Uploaded 2021-05-19 Available
Att I.4_Survey Follow-up Letter_CLEAN.docx Supplementary Document Uploaded 2021-05-19 Missing upstream
Att I.3_Screener Follow-up Letter_CLEAN.docx Supplementary Document Uploaded 2021-05-19 Repair queued
Att I.2_Advance Letter for Survey_CLEAN.docx Supplementary Document Uploaded 2021-05-19 Missing upstream
Att I.1_Advance Letter for Screener_CLEAN.docx Supplementary Document Uploaded 2021-05-19 Repair queued
AttL_Cognitive Testing Protocol.docx Supplementary Document Uploaded 2020-01-06 Missing upstream
AttK.2_NISVS Workgroup Summary.docx Supplementary Document Uploaded 2020-01-06 Missing upstream
AttK.1_NISVS Workgroup Participants.docx Supplementary Document Uploaded 2020-01-06 Repair queued
AttG_PIA_NISVS.pdf Supplementary Document Uploaded 2020-01-06 Missing upstream
AttF_Security Agreement.pdf Supplementary Document Uploaded 2020-01-06 Repair queued
AttD_IRB Approval.pdf Supplementary Document Uploaded 2020-01-06 Repair queued
AttC_Outside Consultation.pdf Supplementary Document Uploaded 2020-01-06 Repair queued
AttB1_60Day - FRN-0822.pdf Supplementary Document Uploaded 2020-01-06 Repair queued
AttA_AuthLeg_0822.docx Supplementary Document Uploaded 2020-01-06 Repair queued
SSB _ 0822 NISVS _3.18.20.docx Supporting Statement B Uploaded 2020-03-19 Missing upstream
SSA _ 0822 NISVS _3.17.20.docx Supporting Statement A Uploaded 2020-03-19 Repair queued
IC Document Collections
IC IDCollectionTypeStatusForm
239172 Phase 3 - ABS inbound CATI Form and Instruction Removed
239171 Phase 3 - ABS phone survey Form and Instruction Modified
239170 Phase 3 - ABS web Survey Form and Instruction Removed
239169 Phase 3 - ABS Web Survey Form and Instruction Modified
239168 Phase 3 - ABS Paper screener - YMOF method Form and Instruction Removed
239167 Phase 3 - ABS, paper screener Form Modified
239165 Phase 3 - ABS, web screener Form and Instruction Modified
239163 Phase 3 - RDD (CATI) screener Form and Instruction Removed
239162 Phase 2 - Cognitive testing Form and Instruction Removed
239161 Phase 2 - Panel, web Survey Form and Instruction Removed
239159 Phase 2 - ABS, in-bound CATI Form and Instruction Removed
239157 Phase 2 - ABS Paper Survey Form and Instruction Removed
239156 Phase 2 - ABS web Survey Form and Instruction Removed
239155 Phase 2 - RDD (CATI) Survey Form and Instruction Removed
239154 Phase 2 - ABS screener, paper YMOF method Form and Instruction Removed
230016 Phase 2 - ABS, paper screener, Roster method Form and Instruction Removed
213548 Phase 2 - ABS web screener Form and Instruction Removed
213547 Phase 2- RDD (CATI) screener Form and Instruction Removed
ICR Details
0920-0822 202105-0920-008
Received in OIRA 202001-0920-001
HHS/CDC 0920-0822-21FG
The National Intimate Partner and Sexual Violence Survey (NISVS)
No material or nonsubstantive change to a currently approved collection   No
Regular 05/26/2021
  Requested Previously Approved
03/31/2023 03/31/2023
534 4,258
101 1,189
2,676 31,405
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 change request is for the pilot testing phase of the NISVS Redesign Study.
US Code: 42 USC 241 Name of Law: Public Health Service Act
  
None
Not associated with rulemaking
  84 FR 2019 10/09/2019
85 FR 4987 01/28/2020
Yes
  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 534 4,258 0 -3,724 0 0
Annual Time Burden (Hours) 101 1,189 0 -1,088 0 0
Annual Cost Burden (Dollars) 2,676 31,405 0 -28,729 0 0
Yes
Miscellaneous Actions
Yes
Miscellaneous Actions
This change request is for pilot testing as discussed in the previously approved ICR. Updated documents were not included in the previous submission making this request seem somewhat incongruous with requested changes.
$3,725,698
Yes Part B of Supporting Statement
    Yes
    Yes
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.
05/26/2021