Information Collection

Youth

IC 203550 under ICR 201208-0930-001 · OMB 0930-0298.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0930-0298 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form Youth Questionnair Youth	Form
Youth Questionnair Youth Questionnaire HIV Youth Questionnaire_120321.docx	Form
HIV Youth Admin Guide 120321_Cleaned.docx Youth Admin Guide	IC Document

IC Title:

Youth

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	Youth Questionnaire	Youth Questionnaire	HIV Youth Questionnaire_120321.docx		Yes	Yes	Fillable Printable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 2,126

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	3,692	3,692
Annual IC Time Burden (Hours)	2,709	2,709
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Youth Admin Guide	HIV Youth Admin Guide 120321_Cleaned.docx	07/16/2012

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