Youth Survey--Supplemental: 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⚠️ Notice: This information collection may be referencing outdated material.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 9. Youth Survey ExPECTT 3_FU Waves.docx Other-ENGLISH Youth Survey ExPECTT 3
Attachment 9. Youth Survey ExPECTT 3_FU Waves.docx Other-ENGLISH Youth Survey ExPECTT 3
Attachment 9. Youth Survey ExPECTT 3_FU Waves_SPA.docx Other-SPANISH Youth Survey ExPECTT 3
Attachment 9. Youth Survey ExPECTT 3_FU Waves_SPA.docx Other-SPANISH Youth Survey ExPECTT 3

Information Collection (IC) Details

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

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-ENGLISH Youth Survey ExPECTT 3 Baseline			Attachment 9. Youth Survey ExPECTT 3_FU Waves.docx		Yes	Yes	Fillable Printable
Other-SPANISH Youth Survey ExPECTT 3_Baseline			Attachment 9. Youth Survey ExPECTT 3_FU Waves_SPA.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: 4,428	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 99 %

	Approved	Previously Approved
Annual Number of Responses for this IC	4,428	4,428
Annual IC Time Burden (Hours)	2,214	2,214
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.