Information Collection

Semi-structured interviews with Adolescents(13 to 20 years of age)

IC 189143 under ICR 200905-0935-002 · OMB 0935-0154.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form Form #5 Semi-structured interviews with Adolescents(13 to 20 years of age)	Form
Form #5 Semi-structured interviews with Adolescents Attachment E--Semi-structured interview with Adolscents.pdf	Form
Attachment E1 -- Adolescent Recruit Letter.doc Attachment E1 -- Adolescent Recruit Letter	IC Document

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	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	Form #5	Semi-structured interviews with Adolescents	Attachment E--Semi-structured interview with Adolscents.pdf		No		Paper Only

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 20

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	20	20
Annual IC Time Burden (Hours)	10	10
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Attachment E1 -- Adolescent Recruit Letter	Attachment E1 -- Adolescent Recruit Letter.doc	05/11/2009

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