Information Collection

NYTS Cognitive Testing Youth Recruitment Screener Questionnaire

IC 229816 under ICR 202203-0920-009 · OMB 0920-0621.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0621 can be found here:

Documents and Forms

Document Name Document Type
Form 0920-0621 NYTS Cognitive Testing Youth Recruitment Screener Questionnaire Form and Instruction
0920-0621 NYTS Cognitive Testing Youth Recruitment Screener Questi Attachment R5_NYTS Cog Testing Youth Screener_(2022.03.29).docx Form and Instruction
0920-0621 NYTS Cognitive Testing Youth Recruitment Screener Questi Attachment R5_NYTS Cog Testing Youth Screener_(2022.03.29).docx Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	NYTS Cognitive Testing Youth Recruitment Screener Questionnaire	Agency IC Tracking Number:	0920-062-=22DZ

Is this a Common Form? No		IC Status: Modified

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	0920-0621	NYTS Cognitive Testing Youth Recruitment Screener Questionnaire	Attachment R5_NYTS Cog Testing Youth Screener_(2022.03.29).docx		No		Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 300	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Previously Approved
Annual Number of Responses for this IC	300	300
Annual IC Time Burden (Hours)	50	50
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

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.