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Federal forms, ICRs, and supporting documents

Information Collection

Adult and Adolescent Questionnaire

IC 235809 under ICR 202106-0923-001 · OMB 0923-0062.

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

View Information Collection (IC)

Adult and Adolescent Questionnaire 0923-0062
 
No Modified
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction 0923-0062 Adult/Ado Field Questionnaire P_AppxN4a_Adult-AdoQx 20210222 cln.docx Yes No Fillable Fileable

Health Public Health Monitoring

 

100 0
   
Individuals or Households
 
   0 %

  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 100 0 0 0 0 100
Annual IC Time Burden (Hours) 50 0 0 0 0 50
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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.