Information Collection

Youth Assent--Main: Baseline & Follow-up 1,2,3

IC 257759 under ICR 202212-0910-013 · OMB unassigned.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Attachment 5a. Youth Assent 11 to 13 ExPECTT 3_Baseline.docx	Other-ENGLISH Youth Assent 11 to 13
Attachment 5a. Youth Assent 11 to 13 ExPECTT 3_Baseline.docx	Other-ENGLISH Youth Assent 11 to 13
Attachment 5a. Youth Assent 11 to 13 ExPECTT 3_Baseline_SPA_FINAL_rev.docx	Other-SPANISH Youth Assent 11 to 13
Attachment 5a. Youth Assent 11 to 13 ExPECTT 3_Baseline_SPA_FINAL_rev.docx	Other-SPANISH Youth Assent 11 to 13
Attachment 5b. Youth Assent 14+ ExPECTT 3_Baseline.docx	Other-ENGLISH Youth Assent 14+ ExPEC
Attachment 5b. Youth Assent 14+ ExPECTT 3_Baseline.docx	Other-ENGLISH Youth Assent 14+ ExPEC
Attachment 5b. Youth Assent 14+ ExPECTT 3_Baseline_SPA_FINAL_rev.docx	Other-SPANISH Youth Assent 14+ ExPEC
Attachment 5b. Youth Assent 14+ ExPECTT 3_Baseline_SPA_FINAL_rev.docx	Other-SPANISH Youth Assent 14+ ExPEC
Attachment 6. Young Adult Consent ExPECTT 3_Baseline.docx	Other-ENGLISH Young Adult Consent Ex
Attachment 6. Young Adult Consent ExPECTT 3_Baseline.docx	Other-ENGLISH Young Adult Consent Ex
Attachment 6. Young Adult Consent ExPECTT 3_Baseline_SPA_FINAL_rev.docx	Other-SPANISH Young Adult Consent Ex
Attachment 6. Young Adult Consent ExPECTT 3_Baseline_SPA_FINAL_rev.docx	Other-SPANISH Young Adult Consent Ex

IC Title:

Agency IC Tracking Number:

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	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-ENGLISH Youth Assent 11 to 13 ExPECTT 3 Baseline	Attachment 5a. Youth Assent 11 to 13 ExPECTT 3_Baseline.docx	Yes	Yes	Fillable Printable
Other-SPANISH Youth Assent 11 to 13 ExPECTT 3 Baseline	Attachment 5a. Youth Assent 11 to 13 ExPECTT 3_Baseline_SPA_FINAL_rev.docx	Yes	Yes	Fillable Printable
Other-ENGLISH Youth Assent 14+ ExPECTT 3 Baseline	Attachment 5b. Youth Assent 14+ ExPECTT 3_Baseline.docx	Yes	Yes	Fillable Printable
Other-SPANISH Youth Assent 14+ ExPECTT 3 Baseline	Attachment 5b. Youth Assent 14+ ExPECTT 3_Baseline_SPA_FINAL_rev.docx	Yes	Yes	Fillable Printable
Other-ENGLISH Young Adult Consent ExPECTT 3 Baseline	Attachment 6. Young Adult Consent ExPECTT 3_Baseline.docx	Yes	Yes	Fillable Printable
Other-SPANISH Young Adult Consent ExPECTT 3 Baseline	Attachment 6. Young Adult Consent ExPECTT 3_Baseline_SPA_FINAL_rev.docx	Yes	Yes	Fillable Printable

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 21,600

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 99 %

table that charts list of burden
	Requested	Change Due to Adjustment in Agency Estimate
Annual Number of Responses for this IC	21,600	21,600
Annual IC Time Burden (Hours)	1,728	1,728
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.