Information Collection

Youth Serving Organization (YSO) Organizational Assessment

IC 222368 under ICR 201912-0920-012 · OMB 0920-1156.

Documents and Forms

Document Name Document Type
Youth Serving Organization (YSO) Organizational Assessment Form and Instruction
Att 6a Health Center Youth Survey Online Version Att 6 Health Center Youth Survey clean.docx Form and Instruction
Att 6a Health Center Youth Survey Online Version Att 6a Health Center Youth Survey Online Version.docx Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Youth Serving Organization (YSO) Organizational Assessment	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Removed

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	N/A	Att 6a Health Center Youth Survey Online Version	Att 6 Health Center Youth Survey clean.docx		Yes	Yes	Fillable Printable
Form	N/A	Att 6a Health Center Youth Survey Online Version	Att 6a Health Center Youth Survey Online Version.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 15	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 0 %

	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	-15	15
Annual IC Time Burden (Hours)	-15	15
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

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.