Information Collection

Longitudinal Cohort Youth Post-Test Outcome Survey

IC 215944 under ICR 201603-0910-010 · OMB 0910-0788.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0910-0788 can be found here:

Documents and Forms

Document Name Document Type
Attachment 1_ Post Campaign Instrument.docx Other-Post Campaign Instrument.
Attachment 8a_Outcome Parent Lead Letter Longitudinal.docx Other-Outcome Parent Lead Letter Lon
Attachment 10_Parent Second Mailing.docx Other-Parent Second Mailing
Attachment 13_Unable to Contact Letters.docx Other-Unable to Contact Letters
Attachment 17_Verification Call Script.docx Other-Verification Call Script

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Longitudinal Cohort Youth Post-Test Outcome 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	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Post Campaign Instrument.	Attachment 1_ Post Campaign Instrument.docx	Yes	Yes	Fillable Fileable
Other-Outcome Parent Lead Letter Longitudinal	Attachment 8a_Outcome Parent Lead Letter Longitudinal.docx	No		Paper Only
Other-Parent Second Mailing	Attachment 10_Parent Second Mailing.docx	No		Paper Only
Other-Unable to Contact Letters	Attachment 13_Unable to Contact Letters.docx	No		Paper Only
Other-Verification Call Script	Attachment 17_Verification Call Script.docx	No		Printable Only

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 4,095	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	Previously Approved
Annual Number of Responses for this IC	4,095	-741	4,836
Annual IC Time Burden (Hours)	3,072	2,992	80
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.