OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

Community-Based Organization HIV Prevention Survey

IC 243303 under ICR 202210-0920-004 · OMB 0920-1321.

Documents and Forms
Document Name
Document Type
Form and Instruction
Form and Instruction
Form and Instruction
IC Document
IC Document
IC Document
IC Document
Information Collection (IC) Details

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Community-Based Organization HIV Prevention Survey 0920-20HR
 
No Modified
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction None CBO HIV Prevention Survey Att 5a_CBO Survey Instrument_10172022_clean.docx Yes Yes Fillable Fileable

Health Health Care Services

 

330 30
   
Private Sector Businesses or other for-profits, Not-for-profit institutions
 
   100 %

  Requested Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 330 0 0 0 0 330
Annual IC Time Burden (Hours) 193 0 28 0 0 165
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
CBO HIV Prevention Survey Screenshots Att 5b_Survey Instrument.pdf 08/25/2020
Survey with Oct 2022 Monkeypox questions in tracked-changes Att 5a_CBO Survey Instrument_10172022_tracked.docx 10/17/2022
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.