OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

Youth Online Screener– Outcome Survey

IC 215947 under ICR 201901-0910-003 · OMB 0910-0788.

Documents and Forms

Documents and forms in this information collection
Document NameDocument Type
Attachment 05c_Parental Permission_Youth Assent_Longitudinal Age 12-17_Web_FU5.docx Other-Longitudinal Web Consent and A
Attachment 05d_Informed Consent_Longitudinal Age 18_Web_FU5.docx Other-Longitudinal Web Consent 18+ Y
Attachment 05e_Youth Assent_Cross Sectional Age 15 - 17_Social Media_Web_FU5.docx Other-Cross Sectional Social Media_S
Attachment 05f_Youth Assent_Cross Sectional Age 13 - 14_Social Media_Web_FU5.docx Other-Youth Assent Cross Sectional A
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 03_EFECT_Outcome_Web_Screener_FU5.docx Other-Outcome Web Screener

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-Longitudinal Web Consent and Assent Attachment 05c_Parental Permission_Youth Assent_Longitudinal Age 12-17_Web_FU5.docx Yes Yes Printable Only
Other-Longitudinal Web Consent 18+ Year Old Youth Attachment 05d_Informed Consent_Longitudinal Age 18_Web_FU5.docx Yes Yes Printable Only
Other-Youth Assent Longitudinal Age 15 - 17 Social Media Permission Waived Web Attachment 05i_Youth Assent_ Age 15 - 17_Social Media_Permission Waived_Web_FU5.docx Yes Yes Fillable Fileable
Other-Outcome Web Screener Attachment 03_EFECT_Outcome_Web_Screener_FU5.docx Yes Yes Fillable Fileable
Other-Cross Sectional Social Media_Snowball 15+ Youth Attachment 05e_Youth Assent_Cross Sectional Age 15 - 17_Social Media_Web_FU5.docx Yes Yes Fillable Fileable
Other-Youth Assent Cross Sectional Age 13 - 14 Social Media Web Attachment 05f_Youth Assent_Cross Sectional Age 13 - 14_Social Media_Web_FU5.docx Yes Yes Fillable Fileable
Other-Youth Assent Longitudinal Age 13 - 17 Social Media Web Attachment 05g_Youth Assent_Longitudinal Age 13 - 17_Social Media_Web_FU5.docx Yes Yes Fillable Fileable

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 40,000 0 0 0 0 40,000
Annual IC Time Burden (Hours) 3,332 0 0 0 0 3,332
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.