Pre-Test 1 (Parents of youth ages 13-17) Informed Parental Consent

Pilot Implementation of the Violence Against Children and Youth Survey (VACS) in the US

Documents and Forms

Document Name Document Type
Pre-Test 1 (Parents of youth ages 13-17) Informed Parental Consent Form and Instruction
Informed parental consent Attachment D.1_Cognitive Interviewing_Parent Guardian Permission.docx Form and Instruction
Informed parental consent Attachment D.1_Cognitive Interviewing_Parent Guardian Permission.docx Form and Instruction

Information Collection (IC) Details

IC Title:	Pre-Test 1 (Parents of youth ages 13-17) Informed Parental Consent	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Unchanged

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	NA	Informed parental consent	Attachment D.1_Cognitive Interviewing_Parent Guardian Permission.docx	NA	Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 6	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Requested	Previously Approved
Annual Number of Responses for this IC	6	6
Annual IC Time Burden (Hours)	1	1
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.