Information Collection

Youth Pre-Test – Outcome Survey

IC 215943 under ICR 201808-0910-001 · 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⚠️ Notice: This information collection may be referencing outdated material.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 01_Post Campaign Instrument_FU4.docx Other-Post Campaign Instrument
Attachment 11_Welcome to the Study Letter_FU4.docx Other-Welcome to the Study Letter
Attachment 17_Verification Call Script.docx Other-Verification Call Script

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Youth Pre-Test â Outcome Survey	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Unchanged

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Post Campaign Instrument	Attachment 01_Post Campaign Instrument_FU4.docx	Yes	Yes	Fillable Printable
Other-Welcome to the Study Letter	Attachment 11_Welcome to the Study Letter_FU4.docx	No		Paper Only
Other-Verification Call Script	Attachment 17_Verification Call Script.docx	No		Paper Only

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 2,194	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Change Due to Potential Violation of the PRA
Annual Number of Responses for this IC	2,194	2,194
Annual IC Time Burden (Hours)	1,097	1,097
Annual IC Cost Burden (Dollars)	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.