Information Collection

Adolescent Development Products Feedback Survey and We Think Twice Digital Media Campaign

IC 259438 under ICR 202403-0970-001 · 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⚠️ Notice: This information collection may be referencing outdated material.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
Attachment 1_Discussion Prompts_OMB_fnl 5.9.23.docx	Other-Survey
Attachment 1_Discussion Prompts_OMB_fnl 5.9.23.docx	Other-Survey
Insider Parent Consent Form_OMB_01.17.23_Remote Testing.docx Parental Consent Form	IC Document
Insider Parent Consent Form_OMB_01.17.23_Remote Testing.docx Parental Consent Form	IC Document
Insider Youth Assent Form__OMB_02-13-23_Remote Testing.docx Youth Consent Form	IC Document
Insider Youth Assent Form__OMB_02-13-23_Remote Testing.docx Youth Consent Form	IC Document
Fast-track-PRA-submission-short-form_OMB__Remote Testing_fnl 5.9.23.docx Fast Track Submission Template	IC Document
Fast-track-PRA-submission-short-form_OMB__Remote Testing_fnl 5.9.23.docx Fast Track Submission Template	IC Document

IC Title:

Adolescent Development Products Feedback Survey and We Think Twice Digital Media Campaign

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-Survey			Attachment 1_Discussion Prompts_OMB_fnl 5.9.23.docx		Yes	Yes	Fillable Fileable

Line of Business: Community and Social Services

Subfunction: Social Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 70

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	4,200	4,200
Annual IC Time Burden (Hours)	1,386	1,386
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Parental Consent Form	Insider Parent Consent Form_OMB_01.17.23_Remote Testing.docx	03/31/2023
Youth Consent Form	Insider Youth Assent Form__OMB_02-13-23_Remote Testing.docx	03/31/2023
Fast Track Submission Template	Fast-track-PRA-submission-short-form_OMB__Remote Testing_fnl 5.9.23.docx	05/11/2023

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