Information Collection

Parent Screener--Main: Baseline & Follow-up 2 Replenishment

IC 257638 under ICR 202506-0910-001 · OMB 0910-0915.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Attachment 2. Parent Guardian Online Screener ExPECTT 3.docx	Other-ENGLISH Parent Guardian Online
Attachment 2. Parent Guardian Online Screener ExPECTT 3_SPA_FINAL_rev.docx	Other-SPANISH Parent Guardian Online

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Removed

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-ENGLISH Parent Guardian Online Screener ExPECTT 3					Yes	Yes	Fillable Fileable Signable
Other-SPANISH Parent Guardian Online Screener ExPECTT 3					Yes	Yes	Fillable Fileable Signable

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 272,500

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 99 %

table that charts list of burden
	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	-272,500	272,500
Annual IC Time Burden (Hours)	-21,800	21,800
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
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.

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