Information Collection

Consent for Assessment

IC 262899 under ICR 202502-2528-005 · OMB 2528-0337.

Documents and Forms

Document Name Document Type
Final EOrev.Attachment G_The Child Assessment & The Obesity and Type II Diabetes Risk Assessment_Assent.docx Other-Consent for Assessment
Final EOrev.Attachment G_The Child Assessment & The Obesity and Type II Diabetes Risk Assessment_Assent.docx Other-Consent for Assessment

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Consent for Assessment	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-Consent for Assessment			Final EOrev.Attachment G_The Child Assessment & The Obesity and Type II Diabetes Risk Assessment_Assent.docx		Yes	Yes	Fillable Fileable

Line of Business: Community and Social Services

Subfunction: Community and Regional Development

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 837	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Previously Approved
Annual Number of Responses for this IC	1,674	1,674
Annual IC Time Burden (Hours)	218	218
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.