Information Collection

Adolescent Survey

IC 249739 under ICR 202110-0704-005 · OMB 0704-0635.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0704-0635 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
0704-AWBS_Adolescent_1.19.22.pdf	Other-Survey
0704-AWBS_Adolescent Survey_11-12year olds_8.23.22.docx	Other-Survey
0704-AWBS_AdolescentSurvey_13-17year olds_8.23.22.docx	Other-Survey

IC Title:

Adolescent Survey

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

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
Other-Survey					Yes	Yes	Fillable Fileable
Other-Survey					Yes	Yes	Fillable Fileable

Line of Business: Defense and National Security

Subfunction: Operational Defense

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 3,200

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	3,200	3,200
Annual IC Time Burden (Hours)	1,600	1,600
Annual IC Cost Burden (Dollars)	11,600	11,600

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.

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