Information Collection

Youth Survey of Relationships, Education, and Behavior

IC 247511 under ICR 202206-0970-010 · OMB 0970-0531.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0970-0531 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Instrument 1. Youth Survey of Relationships Education and Behavior_clean.docx	Other-Survey
Generic SSA Youth Survey to ACF 5_14_21.docx SSA - Formative Prog Supp GenIC - Youth Survey of Relationships, Education, and Behavior	IC Document
Generic SSB Youth Survey to ACF 5_14_21.docx SSB - Formative Prog Supp GenIC - Youth Survey of Relationships, Education, and Behavior	IC Document
Appendix A. Parent Consent Form.docx Appendix A. Parent Consent Form	IC Document
Appendix B. Youth Assent Form.docx Appendix B. Youth Assent	IC Document
Appendix C. Item by Item Source Crosswalk for Survey.docx Appendix C. Item by Item Source Crosswalk for Survey	IC Document

IC Title:

Youth Survey of Relationships, Education, and Behavior

Agency IC Tracking Number:

IC Status: Unchanged

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			Instrument 1. Youth Survey of Relationships Education and Behavior_clean.docx		Yes	Yes	Fillable Fileable

Line of Business: Community and Social Services

Subfunction: Social Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 500

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Requested	Previously Approved
Annual Number of Responses for this IC	500	500
Annual IC Time Burden (Hours)	210	210
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
SSA - Formative Prog Supp GenIC - Youth Survey of Relationships, Education, and Behavior	Generic SSA Youth Survey to ACF 5_14_21.docx	05/19/2021
SSB - Formative Prog Supp GenIC - Youth Survey of Relationships, Education, and Behavior	Generic SSB Youth Survey to ACF 5_14_21.docx	05/19/2021
Appendix A. Parent Consent Form	Appendix A. Parent Consent Form.docx	05/19/2021
Appendix B. Youth Assent	Appendix B. Youth Assent Form.docx	05/19/2021
Appendix C. Item by Item Source Crosswalk for Survey	Appendix C. Item by Item Source Crosswalk for Survey.docx	05/19/2021

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