Information Collection

Att H1_Permission Form Tracking Log for the National YRBS

IC 184920 under ICR 202608-0920-003 · OMB 0920-0493.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 0920-0493 Permission Form Tracking Log for the National YRBS Att H1_Permission Form Tracking Log for the National YRBS	Form and Instruction
0920-0493 Permission Form Tracking Log for the National YRBS Att H1_Permission Form Tracking Log for the national YRBS.docx	Form and Instruction

IC Title:

Agency IC Tracking Number:

0920-0493

Is this a Common Form? No

IC Status: Unchanged

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	0920-0493			NA	No		Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 440

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 50 %

table that charts list of burden
	Requested	Previously Approved
Annual Number of Responses for this IC	440	440
Annual IC Time Burden (Hours)	110	110
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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