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Pre-Test 1 (Youth ages 13-24) Cognitive Interview Protocol
Pilot Implementation of the Violence Against Children and Youth Survey (VACS) in the US
OMB: 0920-1356
IC ID: 250646
OMB.report
HHS/CDC
OMB 0920-1356
ICR 202208-0920-008
IC 250646
( )
Documents and Forms
Document Name
Document Type
Pre-Test 1 (Youth ages 13-24) Cognitive Interview Protocol
Form and Instruction
Cognitive Interview Protocol
Attachment Q_Cognitive Interview Protocol.docx
Form and Instruction
Cognitive Interview Protocol
Attachment Q_Cognitive Interview Protocol.docx
Form and Instruction
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Pre-Test 1 (Youth ages 13-24) Cognitive Interview Protocol
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Unchanged
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
Cognitive Interview Protocol
Attachment Q_Cognitive Interview Protocol.docx
NA
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:
10
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
10
0
0
0
0
10
Annual IC Time Burden (Hours)
20
0
0
0
0
20
Annual IC Cost Burden (Dollars)
0
0
0
0
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.