Youth

Minority Substance Abuse/HIV Prevention Initiative

⚠️ Notice: This information collection may be referencing outdated material.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

Documents and Forms

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

Information Collection (IC) Details

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:

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 %

	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

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.