Information Collection

Student Survey - 6th Grade Students in Non-PYFP Schools

IC 224683 under ICR 201611-0920-009 · OMB 0920-1167.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Student Survey - 6th Grade Students in Non-PYFP Schools	Form and Instruction
Student Survey - 6th Grade Students in Non-PYFP Schools Att 20b Student Survey (non-PYFP Schools).docx	Form and Instruction

IC Title:

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 and Instruction	NA	Student Survey - 6th Grade Students in Non-PYFP Schools	Att 20b Student Survey (non-PYFP Schools).docx	NA	No		Paper Only

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 615

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

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	615	615
Annual IC Time Burden (Hours)	154	154
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
No associated records found

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