YCC Student Baseline Information Form (Individuals)

Youth Career Connect Impact and Implementation Evaluation

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1291-0003 can be found here:

Documents and Forms

Document Name Document Type
YCC Student BIF.docx Other-YCC Student BIF

Information Collection (IC) Details

IC Title:	YCC Student Baseline Information Form (Individuals)	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
Other-YCC Student BIF			YCC Student BIF.docx		No		Paper Only

Line of Business: Community and Social Services

Subfunction: Social Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 4,000	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	1,333	1,333
Annual IC Time Burden (Hours)	467	467
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.