Information Collection

Youth Survey

IC 184508 under ICR 200804-0990-001 · OMB 0990-0325.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0990-0325 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
0990-PSUNCAPPENDIX B.doc	Other-Survey
0990-PSUNCAPPENDIX C.doc	Other-email reminder
0990-psuncConfidentiality Certificate.pdf	Other-Confidential Certificate
0990-PSUNCAPPENDIX D.doc 0990-PSUNCAPPENDIX D	IC Document

IC Title:

Youth Survey

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Survey	0990-PSUNCAPPENDIX B.doc	No	No	Paper Only
Other-email reminder	0990-PSUNCAPPENDIX C.doc	No	No	Paper Only
Other-Confidential Certificate	0990-psuncConfidentiality Certificate.pdf	No	No	Paper Only

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 760

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	760	760
Annual IC Time Burden (Hours)	253	253
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
0990-PSUNCAPPENDIX D	0990-PSUNCAPPENDIX D.doc	03/10/2008

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.