Information Collection

Adult Parental Permission Process – Outcome Survey

IC 215942 under ICR 201901-0910-003 · OMB 0910-0788.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Attachment 05a_Parental Permission_Youth Assent_Longitudinal Age 12- 17_Household_FU5.docx	Other-Longitudinal Informed Consent
Attachment 08a_Outcome Parent Lead Letter_Longitudinal_FU5.docx	Other-Outcome Parent Lead Letter (Lo
Attachment 05c_Parental Permission_Youth Assent_Longitudinal Age 12-17_Web_FU5.docx	Other-Longitudinal Informed Consent

IC Title:

Adult Parental Permission Process â Outcome Survey

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

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-Longitudinal Informed Consent and Assent (Household)	No		Printable Only
Other-Outcome Parent Lead Letter (Longitudinal)	No		Paper Only
Other-Longitudinal Informed Consent and Assent (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: 30,905

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	Previously Approved
Annual Number of Responses for this IC	30,905	30,905
Annual IC Time Burden (Hours)	513	513
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.

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