OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

DGA 2010 Formative Research to Inform Public

IC 195224 under ICR 200910-0584-002 · OMB 0584-0523.

Documents and Forms
Document Name
Document Type
Other-Parental Consent Form
Other-Adult Survey
Other-Kids Survey
IC Document
IC Document
IC Document
IC Document
IC Document
Information Collection (IC) Details

View Information Collection (IC)

DGA 2010 Formative Research to Inform Public
 
New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-Adult Survey Attachment_D v2_Adult_Survey 12 2 10.pdf www.knowledgenetworks.org Yes Yes Fillable Fileable Signable
Other-Kids Survey Attachment E Youth Survey12 2 10.pdf www.knowledgenetworks.org Yes Yes Fillable Fileable Signable
Other-Parental Consent Form ATTACHMENT B informed consent form 12.2.10.doc www.knowledgenetworks.org Yes Yes Fillable Fileable Signable

Health Public Health Monitoring

 

5,075 0
   
Individuals or Households
 
   0 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 5,075 0 5,075 0 0 0
Annual IC Time Burden (Hours) 2,065 0 2,065 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
OMB Justification OMB Justification 11-16-10.docx 11/16/2010
Privacy Statement Attachment C Privacy Statement 11-16-10.docx 11/16/2010
Invitation Letter Attachment A Invitation.docx 11/18/2010
Final - OMB Justification OMB Justification 12 2 10 Revised.docx 12/06/2010
Final - Privacy Statement Attachment C Privacy Statement11.12.10.FINAL.docx 12/06/2010
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.