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Federal forms, ICRs, and supporting documents

Information Collection

Activity 2 - Adult and Adolescent Questionnaire (Adult/Adolescent Facility Users)

IC 222463 under ICR 201608-0923-002 · OMB 0923-0054.

Documents and Forms
Document Name
Document Type
Form and Instruction
Form and Instruction
Information Collection (IC) Details

View Information Collection (IC)

Activity 2 - Adult and Adolescent Questionnaire (Adult/Adolescent Facility Users)
 
No Unchanged
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction NA Activity 2 - Adult and Adolescent Questionnaire (Adult/Adolescent Facility Users) Att5d FieldUser AdultAdolescent Questionnaire_20160716 clean.docx NA Yes Yes Fillable Fileable

Health Public Health Monitoring

09-19-0001 Record of Persons Exposed or Potentially Exposed to Toxic or Hazardous Substances  57 FR 62814

36 0
   
Individuals or Households
 
   100 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 36 0 0 0 0 36
Annual IC Time Burden (Hours) 18 0 0 0 0 18
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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