Information Collection

"Talk. They Hear You" PSAs for Parents

IC 229064 under ICR 201608-0930-002 · OMB 0930-0196.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0930-0196 can be found here:

Documents and Forms

Document Name Document Type
Form Focus Group Protoc "Talk. They Hear You" PSAs for Parents Form and Instruction
Focus Group Protoc Focus Group Protocol 2017_9_20_OMB Package_UAD_Focus Group Protocol_Attachment A.docx Form and Instruction
2017_9_20_UAD_ PSA Screener_Attachment B.docx Screener IC Document
2017_9_20_UAD_Consent Form_Attachment C.docx Consent Form IC Document
2017_9_20_UAD_Facilitator Guide_Attachment D.docx Facilitator Guide IC Document
2017_09_20_OMB 2017_Package_UAD_Focus Group.docx Supporting Statement IC Document
TransLet-5doc.doc Transmittal Letter IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	"Talk. They Hear You" PSAs for Parents	Agency IC Tracking Number:

IC Status: New

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	Focus Group Protocol	Focus Group Protocol	2017_9_20_OMB Package_UAD_Focus Group Protocol_Attachment A.docx		No		Fillable Printable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 96	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	96	96
Annual IC Time Burden (Hours)	128	128
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Screener	2017_9_20_UAD_ PSA Screener_Attachment B.docx	11/16/2017
Consent Form	2017_9_20_UAD_Consent Form_Attachment C.docx	11/16/2017
Facilitator Guide	2017_9_20_UAD_Facilitator Guide_Attachment D.docx	11/16/2017
Supporting Statement	2017_09_20_OMB 2017_Package_UAD_Focus Group.docx	11/16/2017
Transmittal Letter	TransLet-5doc.doc	11/16/2017

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