Information Collection

Vineland Adaptive Behavior Scales (for Covid-19 Impact Assessment)

IC 244369 under ICR 202011-0920-014 · OMB 0920-1171.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-1171 can be found here:

Documents and Forms

Document Name Document Type
Vineland Adaptive Behavior Scales (for Covid-19 Impact Assessment) Form and Instruction
Vineland Adaptive Behavior Scales, second edition, Surve ITEM #6 Appendix C.4_COV-IMP_Vineland Scoresheet.pdf Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Vineland Adaptive Behavior Scales (for Covid-19 Impact Assessment)	Agency IC Tracking Number:

Is this a Common Form? No		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 and Instruction	n/a	Vineland Adaptive Behavior Scales, second edition, Survey Interview Form	ITEM #6 Appendix C.4_COV-IMP_Vineland Scoresheet.pdf		No		Paper Only

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title: 09-20-0136, Epidemiologic Studies and Surveillance of Disease Problems	FR Citation: 81 FR 9200

Number of Respondents: 1,330	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Requested	Previously Approved
Annual Number of Responses for this IC	1,330	1,330
Annual IC Time Burden (Hours)	333	333
Annual IC Cost Burden (Dollars)	8,552	8,552

Documents for IC

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