Information Collection

Attachment B19. Strengths and Difficulties Questionnaire (4-10) (Parent)

IC 179842 under ICR 200704-0920-003 · OMB 0920-0747.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0747 can be found here:

Documents and Forms

Document Name Document Type
Attachment B19. Strengths and Difficulties Questionnaire (4-10) (Parent) Form and Instruction
Strengths and Difficulties Questionnaire (4-10) Attachment B19 Parent Strengths and Difficulties Questionnaire 4-10 scan.doc Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Attachment B19. Strengths and Difficulties Questionnaire (4-10) (Parent)	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	None	Strengths and Difficulties Questionnaire (4-10)	Attachment B19 Parent Strengths and Difficulties Questionnaire 4-10 scan.doc		No	No	Paper Only

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title: 09-20-0136 - Epidemiologic Studies and Surveillance of Disease Problems	FR Citation: 57 FR 62812

Number of Respondents: 163	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	326	326
Annual IC Time Burden (Hours)	16	16
Annual IC Cost Burden (Dollars)	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.