Information Collection

Sexual Risk Avoidance (SRA) Social Media Marketing Campaign

IC 233069 under ICR 201801-0970-013 · OMB 0970-0401.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0970-0401 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1 Sexual Risk Avoidance (SRA) Social Media Marketing Campaign	Form and Instruction
1 Attachment 1 Discussion Prompts Attachment 1_Discussion Prompts_OMB_8-30-18_Remote Testing.docx	Form and Instruction
1 CTK Parent Consent Form CTK Parent Consent Form_OMB_8-29-18_Remote Testing.docx	Form and Instruction
1 CTK Youth Assent Form CTK Youth Assent Form__OMB_8-29-18_Remote Testing.docx	Form and Instruction
1 Display DISPLAY.doc	Form and Instruction
1 Youth Assent Form The Hive Youth Assent Form_The Hive_OMB_9.3.18_Remote Testing.docx	Form and Instruction
fast-track-PRA-submission-short-form_OMB_8-30-18_Remote Testing.doc Justification	IC Document

IC Title:

Sexual Risk Avoidance (SRA) Social Media Marketing Campaign

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	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	1	Attachment 1 Discussion Prompts	Attachment 1_Discussion Prompts_OMB_8-30-18_Remote Testing.docx	Yes	Yes	Fillable Printable
Form and Instruction	1	CTK Parent Consent Form	CTK Parent Consent Form_OMB_8-29-18_Remote Testing.docx	Yes	Yes	Fillable Printable
Form and Instruction	1	CTK Youth Assent Form	CTK Youth Assent Form__OMB_8-29-18_Remote Testing.docx	Yes	Yes	Fillable Printable
Form and Instruction	1	Display	DISPLAY.doc	Yes	Yes	Fillable Printable
Form and Instruction	1	Youth Assent Form The Hive	Youth Assent Form_The Hive_OMB_9.3.18_Remote Testing.docx	Yes	Yes	Fillable Printable

Line of Business: Community and Social Services

Subfunction: Social Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 70

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	280	280
Annual IC Time Burden (Hours)	70	70
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Justification	fast-track-PRA-submission-short-form_OMB_8-30-18_Remote Testing.doc	09/19/2018

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