Information Collection

Customer Feedback on CAMP Teen-SPARC Tool Use and Usability

IC 242280 under ICR 201902-0920-022 · OMB 0920-1050.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-1050 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 0920-1050 Customer Feedback on CAMP Teen-SPARC Tool Use and Usability	Form and Instruction
0920-1050 SPARC Survey Att1 teen-SPARC SurveyQuestions.docx	Form and Instruction
Customer Service GenIC Clearance Template_DASH_teen-SPARC.docx Customer Service Template	IC Document

IC Title:

Customer Feedback on CAMP Teen-SPARC Tool Use and Usability

Agency IC Tracking Number:

0920-1050-20PN

IC Status: New

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 and Instruction	0920-1050	SPARC Survey	Att1 teen-SPARC SurveyQuestions.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Illness Prevention

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 100

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	100	100
Annual IC Time Burden (Hours)	17	17
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Customer Service Template	Customer Service GenIC Clearance Template_DASH_teen-SPARC.docx	06/23/2020

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.