Information Collection

Attachment B23. Health Risk Behavior Survey (elementary) (Child)

IC 179846 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⚠️ Notice: This information collection may be referencing outdated material.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 B23. Health Risk Behavior Survey (elementary) (Child) Form and Instruction
Health Risk Behavior Survey (elementary) (Child) Attachment B23 Child Health Risk Behaviors (elementary) reduced.doc Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Attachment B23. Health Risk Behavior Survey (elementary) (Child)	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	Health Risk Behavior Survey (elementary) (Child)	Attachment B23 Child Health Risk Behaviors (elementary) reduced.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	163	163
Annual IC Time Burden (Hours)	68	68
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.