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Peer Recruiters - Recruiter Debriefing Form
Barriers and Facilitators to Expanding the NHBS to Conduct HIV Behavioral Surveillance Among Transgender Women (NHBS-Trans)
OMB: 0920-1262
IC ID: 234908
OMB.report
HHS/CDC
OMB 0920-1262
ICR 201902-0920-007
IC 234908
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-1262 can be found here:
2023-01-09 - No material or nonsubstantive change to a currently approved collection
2022-03-28 - Revision of a currently approved collection
Documents and Forms
Document Name
Document Type
Peer Recruiters - Recruiter Debriefing Form
Form and Instruction
Reruiter Defriefing Form - English
Att 7a_Recruiter Debriefing Form (English).docx
Form and Instruction
Recruiter Debriefing Form - Spanish
Att 7b_Recruiter Debriefing Form (Spanish).docx
Form and Instruction
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Peer Recruiters - Recruiter Debriefing Form
Agency IC Tracking Number:
Is this a Common Form?
No
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
Form and Instruction
NA
Reruiter Defriefing Form - English
Att 7a_Recruiter Debriefing Form (English).docx
NA
No
Paper Only
Form and Instruction
NA
Recruiter Debriefing Form - Spanish
Att 7b_Recruiter Debriefing Form (Spanish).docx
NA
No
Paper Only
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Public Health Monitoring
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
900
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
0 %
Approved
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
900
0
900
0
0
0
Annual IC Time Burden (Hours)
30
0
30
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
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.