Information Collection

Community Based Abstinence Education (Follow-up Test Survey)

IC 190225 under ICR 200908-0970-005 · OMB 0970-0272.

Documents and Forms

Document Name Document Type
Form 1 Community Based Abstinence Education (Follow-up Test Survey) Form
1 Follow-up FR 0970-0272 Core measure survey follow-up (post-post) test 7-27-09.doc Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Community Based Abstinence Education (Follow-up Test Survey)	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	1	Follow-up	FR 0970-0272 Core measure survey follow-up (post-post) test 7-27-09.doc		Yes	Yes	Paper Only

Line of Business: Community and Social Services

Subfunction: Social Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 500,000	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 87 %

	Requested	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	500,000	500,000
Annual IC Time Burden (Hours)	125,000	125,000
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

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.