View Information Collection (IC)
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ICR
View Information Collection (IC)
View Information Collection (IC)
IC Title:
Att I1_Computer Survey (Screenshots)
Agency IC Tracking Number:
16AWN
Is this a Common Form?
No
IC Status:
New
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
Other-WORD
Att I1 - Computer Survey Screenshot Example 1 .jpg
Yes
Yes
Fillable Fileable
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:
6,100
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
100 %
Requested
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
6,100
0
6,100
0
0
0
Annual IC Time Burden (Hours)
3,558
0
3,558
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
Att I1A_ 2017 NYTS Computer Based Pilot (screenshots)
Att I1A - Computer Survey Screenshot Example 1 .jpg
03/01/2017
Att I1B_NYTS Computer Based Pilot (sceenshots)
Att I1B - Computer Survey Screenshot Example 2 .jpg
03/01/2017
Att I2 & 3_Parental Permission Packet
Att I2 & I3_Parental Permission Form Distribution Script .docx
03/01/2017
Att I3_Parental Permission Packet (Spanish)
Att I4_Parental Permission Form and Fact Sheet (Spanish Version).docx
03/01/2017
Att I5_Parental Reminder Notice
Att I5_Parental Permission Form Reminder Notice (English Version).docx
03/01/2017
Att I6_Parental Reminder Notice (Spanish)
Att I6_Parental Permission Form Reminder Notice (Spanish Version).docx
03/01/2017
Att I7_Q&A
Att I7_NYTS QA Script.docx
03/01/2017
Att I8 Example Instrument Testing Activity
Att I8_Example Instrument Testing Activity - 11 09 16.docx
03/01/2017
Att I9 Example Testing Activity
Att I9_Example Testing Activity.docx
03/01/2017
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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