Information Collection

NYTS Cognitive Testing Youth Recruitment Screener Questionnaire

IC 229816 under ICR 202506-0910-008 · OMB 0910-0932.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0910-0932 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 0920-0621 Cognitive Testing Yourh Recruitment Screener NYTS Cognitive Testing Youth Recruitment Screener Questionnaire	Form and Instruction
0920-0621 Cognitive Testing Yourh Recruitment Screener 0621_NYTS_Att_N4_Cognitive Testing Screeners_20240520a_clean.docx	Form and Instruction

IC Title:

NYTS Cognitive Testing Youth Recruitment Screener Questionnaire

Agency IC Tracking Number:

0920-0621

Is this a Common Form? No

IC Status: Modified

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
Form and Instruction	0920-0621			N/A	No		Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 300

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	300	300
Annual IC Time Burden (Hours)	50	50
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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