Information Collection

Young Adults

IC 190911 under ICR 201606-0925-005 · OMB 0925-0610.

Documents and Forms

Document Name Document Type
Form 1 Young Adults Form and Instruction
Attachment 7 Physical Activity Recall 2012.doc Instruction
1 Participant Online Survey Attachment 1B - Participant Online Survey Screenshots.pdf Form and Instruction
Attachment 1A Participant Hard Copy Survey 2012.doc Attachment 1A Participant Hard Copy Survey 2012 IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Young Adults	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Removed

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	Participant Online Survey	Attachment 1B - Participant Online Survey Screenshots.pdf		Yes	Yes	Fillable Fileable
Instruction			Attachment 7 Physical Activity Recall 2012.doc		No	No	Paper Only

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 2,100	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	-2,100	2,100
Annual IC Time Burden (Hours)	-2,100	2,100
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Attachment 1A Participant Hard Copy Survey 2012	Attachment 1A Participant Hard Copy Survey 2012.doc	11/14/2012

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