Information Collection

2021-2023 State-Level Recruitment Script

IC 184919 under ICR 202005-0920-002 · OMB 0920-0493.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0493 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 0920-0493 2021-2023 State-Level Recruitment Script	Form and Instruction
0920-0493 State-Level Recruitment Script for YRBS Att L1_State-levelRecruitScript.docx	Form and Instruction

IC Title:

2021-2023 State-Level Recruitment Script

Agency IC Tracking Number:

0920-0493

Is this a Common Form? No

IC Status: Modified

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	0920-0493	State-Level Recruitment Script for YRBS	Att L1_State-levelRecruitScript.docx	NA	No		Fillable Printable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 17

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 50 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	17	17
Annual IC Time Burden (Hours)	9	9
Annual IC Cost Burden (Dollars)	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.