Information Collection

Gathering Feedback on the First Year of National Adolescent Health Month

IC 254800 under ICR 202306-0990-006 · OMB 0990-0459.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0990-0459 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
NAHM2022-Survey-OMB-Package_final.docx	Other-survey with script
NAHM2022-Survey-OMB-Package_final.docx	Other-survey with script
NAHM2022-Memo-OMB-Package_final.docx Fast Track Memo	IC Document
NAHM2022-Memo-OMB-Package_final.docx Fast Track Memo	IC Document

IC Title:

Gathering Feedback on the First Year of National Adolescent Health Month

Agency IC Tracking Number:

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-survey with script			NAHM2022-Survey-OMB-Package_final.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 600

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Requested	Previously Approved
Annual Number of Responses for this IC	600	600
Annual IC Time Burden (Hours)	100	100
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Fast Track Memo	NAHM2022-Memo-OMB-Package_final.docx	07/22/2022

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