Information Collection

Children's Wave Survey 2

IC 188672 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
0990-0325Parents Speak Up National Campaign Children's Survey.doc	Other-survey
0990-PSUNCParent E-mail Notification and Consent.doc	Other-notification
0990-0325PSUNCTeen Assent Form.doc	Other-consent form

IC Title:

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-Confidential Certificate	0990-psuncConfidentiality Certificate.pdf	No	No	Paper Only
Other-survey	0990-0325Parents Speak Up National Campaign Children's Survey.doc	No	No	Printable Only
Other-notification	0990-PSUNCParent E-mail Notification and Consent.doc	Yes	Yes	Paper Only
Other-consent form	0990-0325PSUNCTeen Assent Form.doc	Yes	Yes	Paper Only

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 400

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	400	400
Annual IC Time Burden (Hours)	133	133
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.