Information Collection

Youth Survey

IC 184508 under ICR 200904-0990-001 · OMB 0990-0325.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
0990-psuncConfidentiality Certificate.pdf	Other-Confidential Certificate
0990-0325-Youth Survey.doc	Other-Youth Survey

IC Title:

Youth Survey

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Confidential Certificate			0990-psuncConfidentiality Certificate.pdf		No	No	Paper Only
Other-Youth Survey			0990-0325-Youth Survey.doc		No		Fillable Printable

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	Previously Approved
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
No associated records found

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