OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

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

IC 215944 under ICR 201901-0910-003 · OMB 0910-0788.

Documents and Forms

Documents and forms in this information collection
Document NameDocument Type
Attachment 01_EFECT_Post_Campaign_Instrument_FU5.docx Other-Post Campaign Instrument.
Attachment 08a_Outcome Parent Lead Letter_Longitudinal_FU5.docx Other-Outcome Parent Lead Letter Lon
Attachment 13_Unable to Contact Letters_FU5.docx Other-Unable to Contact Letters
Attachment 17_Verification Call Script_Age 13-17_FU5.docx Other-Verification Call Script
Attachment 17a_Verification Call Script Age 18_FU5.docx Other-Verification Call Script Age 1
Attachment 05a_Parental Permission_Youth Assent_Longitudinal Age 12- 17_Household_FU5.docx Other-Parental Permission Youth Asse
Attachment 05c_Parental Permission_Youth Assent_Longitudinal Age 12-17_Web_FU5.docx Other-Parental Permission Youth Asse
Attachment 05d_Informed Consent_Longitudinal Age 18_Web_FU5.docx Other-Informed Consent Longitudinal
Attachment 05g_Youth Assent_Longitudinal Age 13 - 17_Social Media_Web_FU5.docx Other-Youth Assent Longitudinal Age
Attachment 05i_Youth Assent_ Age 15 - 17_Social Media_Permission Waived_Web_FU5.docx Other-Youth Assent_Longitudinal Age
Attachment 08c_Follow-up 18 yo Lead Letter_FU5_NEW.docx Other-Follow-up 18 Lead Letter

Information Collection (IC) Details

View Information Collection (IC)

layout table

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
Other-Post Campaign Instrument. Yes Yes Fillable Fileable
Other-Outcome Parent Lead Letter Longitudinal 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
Other-Follow-up 18 Lead Letter No   Paper Only

Federal Enterprise Architecture Business Reference Module


table that charts list of burden
  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 6,039 0 0 0 0 6,039
Annual IC Time Burden (Hours) 4,530 0 0 0 0 4,530
Annual IC Cost Burden (Dollars) 0 0 0 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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