Information Collection

Youth Suicide Prevention Pre and Post Survey

IC 258802 under ICR 202303-0970-007 · OMB 0970-0401.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0970-0401 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Youth Suicide Prevention pre-survey - Attachment A .docx	Other-Attachment A: Survey
Youth Suicide Prevention pre-survey - Attachment A .docx	Other-Attachment A: Survey
Youth Suicide Prevention post-survey Attachment B.docx	Other-Attachment B: Survey
Youth Suicide Prevention post-survey Attachment B.docx	Other-Attachment B: Survey
Youth Suicide Prevention OMB application.docx Fast Track Submission Template	IC Document
Youth Suicide Prevention OMB application.docx Fast Track Submission Template	IC Document
OMB Slide SRAE Topical Training.pptx PRA Language Slide	IC Document
OMB Slide SRAE Topical Training.pptx PRA Language Slide	IC Document

IC Title:

Youth Suicide Prevention Pre and Post Survey

Agency IC Tracking Number:

FYSB

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-Attachment A: Survey			Youth Suicide Prevention pre-survey - Attachment A .docx		Yes	Yes	Fillable Printable
Other-Attachment B: Survey			Youth Suicide Prevention post-survey Attachment B.docx		Yes	Yes	Fillable Printable

Line of Business: Community and Social Services

Subfunction: Social Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 90

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 25 %

table that charts list of burden
	Requested	Previously Approved
Annual Number of Responses for this IC	90	90
Annual IC Time Burden (Hours)	7	7
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Fast Track Submission Template	Youth Suicide Prevention OMB application.docx	02/27/2023
PRA Language Slide	OMB Slide SRAE Topical Training.pptx	02/27/2023

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