Information Collection

Att 6_Sample Instrument: Parent/Caregiver Survey

IC 231029 under ICR 201808-0920-005 · OMB 0920-1235.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-1235 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 0920-xxxx Att 6_Sample Instrument: Parent/Caregiver Survey	Form
0920-xxxx Sample Instrument: Parent/Caregiver Survey Att 6-Sample Instrument-Parent-Caregiver Survey.docx	Form

IC Title:

Att 6_Sample Instrument: Parent/Caregiver Survey

Agency IC Tracking Number:

0920-18AF

IC Status: Removed

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	0920-xxxx	Sample Instrument: Parent/Caregiver Survey	Att 6-Sample Instrument-Parent-Caregiver Survey.docx		Yes	Yes	Fillable Printable

Line of Business: Health

Subfunction: Illness Prevention

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 7,500

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 25 %

table that charts list of burden
	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	-15,000	15,000
Annual IC Time Burden (Hours)	-6,250	6,250
Annual IC Cost Burden (Dollars)	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.