Information Collection

Longitudinal Cohort Youth Assent/Consent Process and Post-Tests 1-5 – Outcome Survey

IC 215944 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⚠️ Notice: This information collection may be referencing outdated material.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

Documents and forms in this information collection
Document Name	Document Type
Attachment 01_Post Campaign Instrument_FU4.docx	Other-Post Campaign Instrument.
Attachment 08a_Outcome Parent Lead Letter_Longitudinal_FU4.docx	Other-Outcome Parent Lead Letter Lon
Attachment 10_Parent Second Mailing_FU4.docx	Other-Parent Second Mailing
Attachment 13_Unable to Contact Letters_FU4.docx	Other-Unable to Contact Letters
Attachment 17_Verification Call Script_Age 13-17.docx	Other-Verification Call Script
Attachment 17a_Verification Call Script Age 18_NEW.docx	Other-Verification Call Script Age 1
Attachment 05a_Parental Permission_Youth Assent_Longitudinal Age 12- 17_Household_FU4.docx	Other-Parental Permission Youth Asse
Attachment 05c_Parental Permission_Youth Assent_Longitudinal Age 12-17_Web_FU4.docx	Other-Parental Permission Youth Asse
Attachment 05d_Informed Consent_Longitudinal Age 18_Web_FU4.docx	Other-Informed Consent Longitudinal
Attachment 05g_Youth Assent_Longitudinal Age 13 - 17_Social Media_Web_FU4.docx	Other-Youth Assent Longitudinal Age
Attachment 05i_Youth Assent_Longitudinal Age 15 - 17_Social Media_Permission Waived_Web_FU4.docx	Other-Youth Assent_Longitudinal Age

IC Title:

Longitudinal Cohort Youth Assent/Consent Process and Post-Tests 1-5 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:

table that charts list of instruments
Document Type	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Post Campaign Instrument.	Yes	Yes	Fillable Fileable
Other-Outcome Parent Lead Letter Longitudinal	No		Paper Only
Other-Parent Second Mailing	No		Paper Only
Other-Unable to Contact Letters	No		Paper Only
Other-Verification Call Script	No		Printable Only
Other-Verification Call Script Age 18	No		Printable Only
Other-Parental Permission Youth Assent Longitudinal Age 12-17 (Household)	No		Paper Only
Other-Parental Permission Youth Assent Longitudinal Age 12-17 (Web)	Yes	Yes	Fillable Printable
Other-Informed Consent Longitudinal Age 18 (Web)	No		Paper Only
Other-Youth Assent Longitudinal Age 13 - 17 Social Media (Web)	Yes	Yes	Fillable Printable
Other-Youth Assent_Longitudinal Age 15 - 17 Social Media Permission Waived (Web)	Yes	Yes	Fillable Printable

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 6,039

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	Change Due to Adjustment in Agency Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses for this IC	6,039	1,200	4,839
Annual IC Time Burden (Hours)	4,530	900	3,630
Annual IC Cost Burden (Dollars)	0	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.

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