Information Collection

ATTACHMENT C24: Social Inventory (High School, 14 plus years)

IC 179847 under ICR 201002-0920-008 · OMB 0920-0747.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 23 ATTACHMENT C24: Social Inventory (High School, 14 plus years)	Form and Instruction
23 ATTACHMENT C24: Social Inventory (High School, 14 plus y Attachment C24 Social Inventory.doc	Form and Instruction

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

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	23	ATTACHMENT C24: Social Inventory (High School, 14 plus years)	Attachment C24 Social Inventory.doc		No	No	Paper Only

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title: 09-20-0136 - Epidemiologic Studies and Surveillance of Disease Problems

FR Citation: 57 FR 62812

Number of Respondents: 153

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	Previously Approved
Annual Number of Responses for this IC	153	-259	412
Annual IC Time Burden (Hours)	26	-180	206
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
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.