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

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

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Semi-structured interviews with Adolescents(13 to 20 years of age)	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	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 %

	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

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.