Sexual Risk Avoidance (SRA) Social Media Marketing Campaign

Fast Track Generic Clearance for Collection of Qualitative Feedback on Agency Service Delivery

⚠️ Notice: This information collection may be referencing outdated material.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

Documents and Forms

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

Information Collection (IC) Details

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:

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 %

	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

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.