Information Collection

Teen Dating Relationships: Opportunities for Youth to Define What's healthy and unhealthy

IC 198095 under ICR 201303-1121-005 · OMB 1121-0333.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Teen Dating Relationships: Opportunities for Youth to Define What's healthy and unhealthy	Form and Instruction
appendices OMBAppendices_final_5_16.pdf www.conceptsystemsglobal.com/TDVpilot/brainstorm	Form and Instruction

IC Title:

Agency IC Tracking Number:

NIJ

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	none	appendices	OMBAppendices_final_5_16.pdf	www.conceptsystemsglobal.com/TDVpilot/brainstorm	Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 495

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 71 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate
Annual Number of Responses for this IC	495	495
Annual IC Time Burden (Hours)	569	569
Annual IC Cost Burden (Dollars)	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.