View Information Collection (IC)

View Information Collection (IC)

IC Title:	2017-2019 District-Level Recruitment Script	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
Form and Instruction	NA	District-Level Recruitment Script for YRBS	App K2_District-level Recruitment Script.docx	NA	No		Fillable Printable

Federal Enterprise Architecture Business Reference Module

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 80	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to New Statute	Program Change Due to Agency Discretion	Change Due to Adjustment in Agency Estimate	Change Due to Potential Violation of the PRA	Previously Approved
Annual Number of Responses for this IC	80	0	80	0	0	0
Annual IC Time Burden (Hours)	40	0	40	0	0	0
Annual IC Cost Burden (Dollars)	0	0	0	0	0	0

Documents for IC

Title	Document	Date Uploaded
Appx H2 - District-level Recruitment Script for the YRBS - supplemental documents	Appx H2 - District-level Recruitment Script for the YRBS - supplemental documents.doc	07/16/2012

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.