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Federal forms, ICRs, and supporting documents

Information Collection

Child Behavior Checklist (for Covid-19 Impact Assessment)

IC 244362 under ICR 202102-0920-008 · OMB 0920-1171.

Documents and Forms
Document Name
Document Type
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
Information Collection (IC) Details

View Information Collection (IC)

Child Behavior Checklist (for Covid-19 Impact Assessment) 0920-21CS
 
No Modified
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction 0920-21CS CBCL Spanish 1-5 Appendix C.1s_COV-IMP_Spanish CBCL_1-5yrs_page 1.jpg No   Paper Only
Form and Instruction 0920-21CS CBCL School Age Appendix C.2_COV-IMP_CBCL_school age.pdf No   Paper Only

Health Public Health Monitoring

09-20-1036, Epidemiologic Studies and Surveillance of Disease Problems  81 FR 9200

1,330 0
   
Individuals or Households
 
   100 %

  Approved 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 1,330 0 0 0 0 1,330
Annual IC Time Burden (Hours) 443 0 0 0 0 443
Annual IC Cost Burden (Dollars) 11,398 0 0 0 0 11,398

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.