[NCHS] Youth Outreach Generic Clearance for the National Center for Health Statistics

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form 0920-1185 Student Evaluation Form	Form and Instruction	New	Repair queued
Form 0920-1185 Parent Evaluation Form	Form and Instruction	New	Repair queued
Form 0920-1185 Registration Form (Virtual)	Form and Instruction	New	Repair queued
Form 0920-1185 Registration Form (In-Person)	Form and Instruction	New	Repair queued
Form 0920-1185 Teacher Recommendation Form	Form and Instruction	New	Repair queued
Form 0920-1185 Student Application Form	Form and Instruction	New	Repair queued
Form 0920-1185 Parent Application Form	Form and Instruction	New	Repair queued
Form 0920-24CH Att G Student Eval Form 1192024	Form and Instruction	Unchanged	Available
Form 0920-24CH Att F Parent Eval Form 1192024	Form and Instruction	Unchanged	Available
Form 0920-24CH Att D Registration Form	Form and Instruction	Unchanged	Available
Form 0920-24CH Att C Teacher Recommendation 1192024	Form and Instruction	Unchanged	Available
Form 0920-24CH Att A Camper Application Form 1192024	Form and Instruction	Unchanged	Repair queued
Form 0920-24CH Att B Parent Application Form 1192024	Form and Instruction	Unchanged	Available
Form 0920-24CH [NCHS] Youth Outreach - Data Detectives Camp	Form and Instruction	Unchanged	Missing upstream
Student Evaluation Form	Form and Instruction	Unchanged	Available
Parent Evaluation Form	Form and Instruction	Unchanged	Available
Camper Information/Registration Form (virtual)	Form and Instruction	Unchanged	Available
Camper Information/Registration Form (in-person)	Form and Instruction	Unchanged	Available
Teacher Recommendation	Form and Instruction	Unchanged	Available
Parent Application Form	Form and Instruction	Unchanged	Available
Camper Application Form	Form and Instruction	Unchanged	Repair queued
[NCHS] NCHS Data Detectives Camp 2023-2025	Form and Instruction	Unchanged	Repair queued
Change Request for Burden Increase.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2024-12-02	Repair queued
Change Request for Burden Increase.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2024-12-02	Repair queued
Attachment B Published 60-Day FRN 9_23_2022.pdf	Supplementary Document	Uploaded 2022-12-08	Available
Attachment B Published 60-Day FRN 9_23_2022.pdf	Supplementary Document	Uploaded 2022-12-08	Repair queued
Att_A Leg NCHS.docx	Supplementary Document	Uploaded 2022-12-08	Available
Att_A Leg NCHS.docx	Supplementary Document	Uploaded 2022-12-08	Repair queued
Att B2 Comments.docx	Supplementary Document	Uploaded 2020-04-30	Available
Att B2 Comments.docx	Supplementary Document	Uploaded 2020-04-30	Repair queued
Youth Outreach SSA 2023_09232022.docx	Supporting Statement A	Uploaded 2022-12-08	Available
Youth Outreach SSA 2023_09232022.docx	Supporting Statement A	Uploaded 2022-12-08	Repair queued
Privacy Act App Review.docx	Supplementary Document	Uploaded 2017-04-04	Repair queued
Privacy Act App Review.docx	Supplementary Document	Uploaded 2017-04-04	Repair queued
Att_B published 60 Day FRN.pdf	Supplementary Document	Uploaded 2017-04-04	Repair queued
Att_B published 60 Day FRN.pdf	Supplementary Document	Uploaded 2017-04-04	Repair queued
Att_A Leg NCHS 2014-2016.docx	Supplementary Document	Uploaded 2017-04-04	Available
Att_A Leg NCHS 2014-2016.docx	Supplementary Document	Uploaded 2017-04-04	Repair queued

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
273469	[NCHS] Data Detectives Camp 2025	Form and Instruction	New	Student Evaluation Form
273469	[NCHS] Data Detectives Camp 2025	Form and Instruction	New	Parent Evaluation Form
273469	[NCHS] Data Detectives Camp 2025	Form and Instruction	New	Registration Form (Virtual)
273469	[NCHS] Data Detectives Camp 2025	Form and Instruction	New	Registration Form (In-Person)
273469	[NCHS] Data Detectives Camp 2025	Form and Instruction	New	Teacher Recommendation Form
273469	[NCHS] Data Detectives Camp 2025	Form and Instruction	New	Student Application Form
273469	[NCHS] Data Detectives Camp 2025	Form and Instruction	New	Parent Application Form
264718	[NCHS] Youth Outreach - Data Detectives Camp	Form and Instruction	Unchanged	Att G Student Eval Form 1192024
264718	[NCHS] Youth Outreach - Data Detectives Camp	Form and Instruction	Unchanged	Att F Parent Eval Form 1192024
264718	[NCHS] Youth Outreach - Data Detectives Camp	Form and Instruction	Unchanged	Att D Registration Form
264718	[NCHS] Youth Outreach - Data Detectives Camp	Form and Instruction	Unchanged	Att C Teacher Recommendation 1192024
264718	[NCHS] Youth Outreach - Data Detectives Camp	Form and Instruction	Unchanged	Att A Camper Application Form 1192024
264718	[NCHS] Youth Outreach - Data Detectives Camp	Form and Instruction	Unchanged	Att B Parent Application Form 1192024
264718	[NCHS] Youth Outreach - Data Detectives Camp	Form and Instruction	Unchanged
258940	[NCHS] NCHS Data Detectives Camp 2023-2025	Form and Instruction	Unchanged	Student Evaluation Form
258940	[NCHS] NCHS Data Detectives Camp 2023-2025	Form and Instruction	Unchanged	Parent Evaluation Form
258940	[NCHS] NCHS Data Detectives Camp 2023-2025	Form and Instruction	Unchanged	Camper Information/Registration Form (virtual)
258940	[NCHS] NCHS Data Detectives Camp 2023-2025	Form and Instruction	Unchanged	Camper Information/Registration Form (in-person)
258940	[NCHS] NCHS Data Detectives Camp 2023-2025	Form and Instruction	Unchanged	Teacher Recommendation
258940	[NCHS] NCHS Data Detectives Camp 2023-2025	Form and Instruction	Unchanged	Parent Application Form
258940	[NCHS] NCHS Data Detectives Camp 2023-2025	Form and Instruction	Unchanged	Camper Application Form
258940	[NCHS] NCHS Data Detectives Camp 2023-2025	Form and Instruction	Unchanged

ICR Details

OMB Control No: 0920-1185	ICR Reference No: 202412-0920-001
Status: Historical Active	Previous ICR Reference No: 202212-0920-007
Agency/Subagency: HHS/CDC	Agency Tracking No: 0920-1185
Title: [NCHS] Youth Outreach Generic Clearance for the National Center for Health Statistics
Type of Information Collection: No material or nonsubstantive change to a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 12/31/2024
Retrieve Notice of Action (NOA)	Date Received in OIRA: 12/02/2024
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	03/31/2026	03/31/2026	03/31/2026
Responses	4,950	0	3,450
Time Burden (Hours)	2,300	0	1,750
Cost Burden (Dollars)	0	0	0

---

Abstract: The National Center for Health Statistics (NCHS) places a high priority on providing outreach and quality products and services to the public. In anticipation of increased involvement with the community and a desire to expand on activities that help young people gain more exposure to math and science fields, the NCHS is requesting a Generic Clearance. This Generic Clearance would be for outreach to young people (K through college) and those who support them, such as parents, teachers, and counselors. This Non-Substantive Change Request is submitted to increase the number of available responses and burden hours available in the overarching Generic ICR mechanism and allow for the submission of a Youth Outreach (2025) GenIC.

---

Authorizing Statute(s): US Code: 42 USC 242 Name of Law: U.S. PHSA
  

Citations for New Statutory Requirements: None

---

Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

---

Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	87 FR 58094	09/23/2022
30-day Notice:	Federal Register Citation:	Citation Date:
	87 FR 77838	12/20/2022
Did the Agency receive public comments on this ICR? No

---

Number of Information Collection (IC) in this ICR: 3

table that charts list of burden

IC Title	Form No.	Form Name
[NCHS] Data Detectives Camp 2025	0920-1185, 0920-1185, 0920-1185, 0920-1185, 0920-1185, 0920-1185, 0920-1185	Parent Application Form ,   Student Application Form ,   Teacher Recommendation Form ,   Registration Form (In-Person) ,   Registration Form (Virtual) ,   Parent Evaluation Form ,   Student Evaluation Form
[NCHS] NCHS Data Detectives Camp 2023-2025	None, None, None, None, None, None, None	Camper Application Form ,   Parent Application Form ,   Teacher Recommendation ,   Camper Information/Registration Form (in-person) ,   Camper Information/Registration Form (virtual) ,   Parent Evaluation Form ,   Student Evaluation Form
[NCHS] Youth Outreach - Data Detectives Camp	0920-24CH, 0920-24CH, 0920-24CH, 0920-24CH, 0920-24CH, 0920-24CH	Att B Parent Application Form 1192024 ,   Att A Camper Application Form 1192024 ,   Att C Teacher Recommendation 1192024 ,   Att D Registration Form ,   Att F Parent Eval Form 1192024 ,   Att G Student Eval Form 1192024

---

ICR Summary of Burden

table that charts list of burden

	Total Approved	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	4,950	3,450	0	1,500	0	0
Annual Time Burden (Hours)	2,300	1,750	0	550	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: Change Request is submitted to increase number of available responses and burden hours to allow submission of additional GenIC under overarching mechanism.

---

Annual Cost to Federal Government: $85,000

Does this IC contain surveys, censuses, or employ statistical methods? No

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     No

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? No

---

Common Form ICR:  No

---

On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 12/02/2024

---