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

The Real Cost Campaign Outcomes Evaluation Study: Cohort 3 (Outcomes Study)

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0910-0915 can be found here:

Documents and Forms

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

Information Collection (IC) Details

IC Title:	Youth Assent--Main: Baseline & Follow-up 1,2,3	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Unchanged

Obligation to Respond: Voluntary

CFR Citation:

Information Collection 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 %

	Approved	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

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.