View Information Collection (IC)

View Information Collection (IC)

View Information Collection (IC)

IC Title:	[2022] Children's Forum Data User Survey and Aging Forum Data User Survey	Agency IC Tracking Number:	0920-22DD

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
Form and Instruction	None	Children's Forum Data User Survey	Att A Children_s Forum Data User Survey Questions 2.14.2022 SK.docx		Yes	Yes	Fillable Fileable
Form and Instruction	None	Aging Forum Data User Survey	Att B Aging Forum Data User Survey Questions 2.14.2022 SK.docx		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: 400	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	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	400	0	400	0	0	0
Annual IC Time Burden (Hours)	53	0	53	0	0	0
Annual IC Cost Burden (Dollars)	0	0	0	0	0	0

Documents for IC

Title	Document	Date Uploaded
Supporting Statement Part A	Supporting Statement A_02112022 SK.docx	03/03/2022
Supporting Statement Part B	Supporting Statement B 02112022 SK.docx	03/03/2022

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