Information Collection

AAP 6 Month Follow-up Survey

IC 220412 under ICR 201603-0920-002 · OMB 0920-1129.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-1129 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
AAP 6 Month Follow-up Survey AAP 6 Month Follow-up Survey	Form
AAP 6 Month Follow-up Survey S2 AAP Six Month Follow Up Evaluation Instrument.pdf	Form
I2 AAP Six Month Follow Up Evaluation Survey.docx AAP 6 Month Follow-up Survey - word	IC Document

IC Title:

AAP 6 Month Follow-up Survey

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	none	AAP 6 Month Follow-up Survey	S2 AAP Six Month Follow Up Evaluation Instrument.pdf		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 120

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	120	120
Annual IC Time Burden (Hours)	10	10
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
AAP 6 Month Follow-up Survey - word	I2 AAP Six Month Follow Up Evaluation Survey.docx	03/02/2016

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.