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⚠️ Notice: This information collection may be referencing outdated material.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

Documents and forms in this information collection
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

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:

table that charts list of 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 %

table that charts list of burden
	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

table that charts IC Documents
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.