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Information Collection

Youth ages 13-24 in Baltimore City or Garrett County, Maryland (Pre-test 2, rural feasibility pilot, full implementation pilot) Youth Respondent Questionnaire

IC 250663 under ICR 202208-0920-008 · OMB 0920-1356.

Documents and Forms
Document Name
Document Type
Form and Instruction
Form and Instruction
Form and Instruction
IC Document
IC Document
Information Collection (IC) Details

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Youth ages 13-24 in Baltimore City or Garrett County, Maryland (Pre-test 2, rural feasibility pilot, full implementation pilot) Youth Respondent Questionnaire 0920-22HW
 
No Modified
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction 0920-22HW DVACS Youth Participant Questionnaire Attachment J_DVACS_Youth Participant Questionnaire.pdf Yes Yes Fillable Fileable

Health Public Health Monitoring

 

377 0
   
Individuals or Households
 
   100 %

  Requested Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 377 0 0 0 0 377
Annual IC Time Burden (Hours) 377 0 0 0 0 377
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Yourh Respondent Questionnaire - Closing Attachment J_DVACS_Closing_ Youth Participant Questionnaire_CORE QUESTIONNAIRE CLOSING.pdf 12/03/2021
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.