Information Collection

Adolescents

IC 190911 under ICR 200910-0925-001 · OMB 0925-0610.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0925-0610 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1 Adolescents	Form and Instruction
1 generation Health Study Survey Attach 1.pdf	Form and Instruction
Attach 5.doc Attach 5	IC Document
Attach 7.doc Attach 7	IC Document

IC Title:

Adolescents

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 and Instruction	1	generation Health Study Survey	Attach 1.pdf		Yes	Yes	Paper Only

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 2,700

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	2,700	2,700
Annual IC Time Burden (Hours)	2,025	2,025
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Attach 5	Attach 5.doc	09/24/2009
Attach 7	Attach 7.doc	09/24/2009

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