Brand Ambassador Implementation Survey

Evaluation of Dating Matters: Strategies to Promote Healthy Teen Relationships

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0941 can be found here:

Documents and Forms

Document Name Document Type
Brand Ambassador Implementation Survey Form and Instruction
Brand Ambassador Implementation Survey Atmt_J_Brand_Ambassador_Implementation_Survey[1].docx Form and Instruction

Information Collection (IC) Details

IC Title:	Brand Ambassador Implementation Survey	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

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 and Instruction	None	Brand Ambassador Implementation Survey	Atmt_J_Brand_Ambassador_Implementation_Survey[1].docx		No	No	Paper Only

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 80	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Previously Approved
Annual Number of Responses for this IC	160	160
Annual IC Time Burden (Hours)	53	53
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

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.