Information Collection

First Follow-Up Survey Supplement for Caregivers of Adolescents

IC 255809 under ICR 202208-0920-007 · OMB 0920-1392.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-1392 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 0920 First Follow-Up Survey Supplement for Caregivers of Adolescents	Form
0920 First Follow-up Survey Supplement for Caregivers of Adol Att 4a-b - Adolescent Survey Supplement for SEED 2 Caregivers.pdf	Form
0920 First Follow-up Survey Supplement for Caregivers of Adol Att 4a-b - Adolescent Survey Supplement for SEED 2 Caregivers.pdf	Form

IC Title:

First Follow-Up Survey Supplement for Caregivers of Adolescents

Agency IC Tracking Number:

0920-21IK

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
Form	0920	First Follow-up Survey Supplement for Caregivers of Adolescents	Att 4a-b - Adolescent Survey Supplement for SEED 2 Caregivers.pdf		No		Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 411

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	411	411
Annual IC Time Burden (Hours)	137	137
Annual IC Cost Burden (Dollars)	0	0

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.