Information Collection

Application for Healthy Kids - Business

IC 192128 under ICR 201006-0584-001 · OMB 0584-0555.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Screene-Shots for Challenge Wireframes.docx	Other-Application
Appendix C Contest Application C 9-20-2010.docx	Other-Application

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
Other-Application			Screene-Shots for Challenge Wireframes.docx	www.AppsforHealthyKids.com	Yes	Yes	Fillable Fileable Signable
Other-Application			Appendix C Contest Application C 9-20-2010.docx	www.AppsforHealthyKids.com	Yes	Yes	Fillable Fileable Signable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 75

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	75	0	75
Annual IC Time Burden (Hours)	4,145	1	4,144
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.