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NCHS Data Detective Camp
Youth Outreach Generic Clearance for the National Center for Health Statistics (NCHS)
OMB: 0920-1185
IC ID: 230259
OMB.report
HHS/CDC
OMB 0920-1185
ICR 202004-0920-023
IC 230259
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-1185 can be found here:
2023-01-24 - Extension without change of a currently approved collection
Documents and Forms
Document Name
Document Type
NCHS Data Detective Camp
Form
Parent Application
Att B Parent App 020218.docx
Form
Student Application
Att C Student App 020218.docx
Form
Teacher Recommendation
Att D Teacher Form 020618.docx
Form
Registration
Att E Registration Form 020618.docx
Form
Parent Evaluation
Att F Parent Eval Form 020618.docx
Form
Student Evaluation
Att G Student Eval Form 020618.docx
Form
Supporting Statement A 022318.docx
Supporting Statement A
IC Document
Att A Camp Brochure.docx
Camp Brochure
IC Document
Att H Human Subject Research Determination.pdf
IRB Non-research determination
IC Document
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
NCHS Data Detective Camp
Agency IC Tracking Number:
0920-1185-18SZ
IC Status:
Unchanged
Obligation to Respond:
Voluntary
CFR Citation:
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form
none
Parent Application
Att B Parent App 020218.docx
Yes
Yes
Fillable Fileable
Form
none
Student Application
Att C Student App 020218.docx
Yes
Yes
Fillable Fileable
Form
none
Teacher Recommendation
Att D Teacher Form 020618.docx
Yes
Yes
Fillable Fileable
Form
none
Registration
Att E Registration Form 020618.docx
Yes
Yes
Fillable Fileable
Form
none
Parent Evaluation
Att F Parent Eval Form 020618.docx
Yes
Yes
Fillable Fileable
Form
none
Student Evaluation
Att G Student Eval Form 020618.docx
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Education
Subfunction:
Elementary, Secondary, and Vocational Education
Privacy Act System of Records
Title:
Users of Health Statistics
FR Citation:
56 FR 1324
Number of Respondents:
690
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
100 %
Requested
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
690
0
0
0
0
690
Annual IC Time Burden (Hours)
275
0
0
0
0
275
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
Supporting Statement A
Supporting Statement A 022318.docx
02/26/2018
Camp Brochure
Att A Camp Brochure.docx
02/26/2018
IRB Non-research determination
Att H Human Subject Research Determination.pdf
02/26/2018
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.