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Att M4_Permission Form Tracking Log for the Validation Study
[NCCDPHP] 2025 and 2027 NATIONAL YOUTH RISK BEHAVIOR SURVEY
OMB: 0920-0493
IC ID: 184919
OMB.report
HHS/CDC
OMB 0920-0493
ICR 202405-0920-007
IC 184919
( )
Documents and Forms
Document Name
Document Type
Form 0920-0493
Att M4_Permission Form Tracking Log for the Validation Study
Form and Instruction
0920-0493 Permission Form Tracking Log for the Validation Study
Att H2_Permission Form Tracking Log for the Validation Study.docx
Form and Instruction
0920-0493 Permission Form Tracking Log for the Validation Study
Att H2_Permission Form Tracking Log for the Validation Study.docx
Form and Instruction
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Att M4_Permission Form Tracking Log for the Validation Study
Agency IC Tracking Number:
0920-0493
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
Form and Instruction
0920-0493
Permission Form Tracking Log for the Validation Study
Att H2_Permission Form Tracking Log for the Validation Study.docx
NA
No
Fillable Printable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Public Health Monitoring
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
14
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
50 %
Approved
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
14
0
14
0
0
0
Annual IC Time Burden (Hours)
4
0
4
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
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.