Information Collection

Parent Survey 1 - All parents using the Milestone Tracker app who complete 65% or more of a checklist using the app

IC 258175 under ICR 202605-0920-002 · OMB 0920-1397.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 0920-1397 Parent Survey 1 Parent Survey 1 - All parents using the Milestone Tracker app who complete 65% or more of a checklist using the app	Form and Instruction
Form 0920-1397 Parent Survey 1 - Spanish Parent Survey 1 - All parents using the Milestone Tracker app who complete 65% or more of a checklist using the app	Form and Instruction
0920-1397 Parent Survey 1 E_Parent 1.docx	Form and Instruction
0920-1397 Parent Survey 1 - Spanish MT Parent Survey 1 Spanish FINAL .docx	Form and Instruction

IC Title:

Agency IC Tracking Number:

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	0920-1397			N/A	Yes	Yes	Fillable Fileable
Form and Instruction	0920-1397			N/A	Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 23,000

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Requested	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	23,000	-177,000	200,000
Annual IC Time Burden (Hours)	1,932	-14,735	16,667
Annual IC Cost Burden (Dollars)	0	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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