Information Collection

Young Adult 12 Month Follow-Up Survey

IC 189110 under ICR 201410-0970-006 · OMB 0970-0383.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0970-0383 can be found here:

Documents and Forms

Document Name Document Type
Form 1 Young Adult 12 Month Follow-Up Survey Form and Instruction
1 Young Adult 12 mos Follow Up 2015 Attachment_E_Young Adult 12 mos Follow Up 2015.docx Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Young Adult 12 Month Follow-Up 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	1	Young Adult 12 mos Follow Up 2015	Attachment_E_Young Adult 12 mos Follow Up 2015.docx		Yes	Yes	Fillable Printable

Line of Business: Community and Social Services

Subfunction: Social Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 1,000	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	1,000	1,000
Annual IC Time Burden (Hours)	610	610
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.