Adolescent Assent Instrument (Attachment G2)

The Family Life, Activity, Sun, Health, and Eating Study (NCI)

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0925-0686 can be found here:

Documents and Forms

Document Name Document Type
Form 3 Adolescent Assent Instrument (Attachment G2) Form
3 Adolescent Assent Instrument (Attachment G-2) Attach G2 - Adolescent Assent Instrument.docx Form

Information Collection (IC) Details

IC Title:	Adolescent Assent Instrument (Attachment G2)	Agency IC Tracking Number:

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
Form	3	Adolescent Assent Instrument (Attachment G-2)	Attach G2 - Adolescent Assent Instrument.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records
Title: Clinical, Basic, Population-based Research Studies of the National Institutes of Health	FR Citation: 67 FR 60776

Number of Respondents: 1,250	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	1,250	1,250
Annual IC Time Burden (Hours)	104	104
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

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.