Information Collection

Cross-Sectional Cohort Youth Post-Test Outcome Survey

IC 215945 under ICR 201708-0910-012 · OMB 0910-0788.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0910-0788 can be found here:

Documents and Forms

Document Name Document Type
Attachment 1_Post Campaign Instrument_FU3.docx Other-Post Campaign Instrument
Attachment 17_Verification Call Script_Age 13-17.docx Other-Verification Call Script

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Cross-Sectional Cohort Youth Post-Test Outcome Survey	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

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
Other-Post Campaign Instrument			Attachment 1_Post Campaign Instrument_FU3.docx		Yes	Yes	Fillable Fileable
Other-Verification Call Script			Attachment 17_Verification Call Script_Age 13-17.docx		No		Printable Only

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 1,920	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	1,920	-232	2,152
Annual IC Time Burden (Hours)	1,440	-174	1,614
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

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.