Information Collection

Youth

IC 203550 under ICR 201512-0930-003 · OMB 0930-0298.

Documents and Forms

Document Name Document Type
Form Youth Questionnair Youth Form and Instruction
Youth Questionnair Youth Questionnaire 1.HIV shortened Youth Questionnaire_8-10-2015-OMB.docx Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Youth	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	Youth Questionnaire	Youth Questionnaire	1.HIV shortened Youth Questionnaire_8-10-2015-OMB.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 1,440	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	Previously Approved
Annual Number of Responses for this IC	2,851	-841	3,692
Annual IC Time Burden (Hours)	1,203	-1,506	2,709
Annual IC Cost Burden (Dollars)	0	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.