OMB
.report
Search
Adolescent Development Products Feedback Survey and We Think Twice Digital Media Campaign
Fast Track Generic Clearance for Collection of Qualitative Feedback on Agency Service Delivery
OMB: 0970-0401
IC ID: 259438
OMB.report
HHS/ACF
OMB 0970-0401
ICR 202305-0970-012
IC 259438
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0970-0401 can be found here:
2024-09-25 - No material or nonsubstantive change to a currently approved collection
2024-09-13 - No material or nonsubstantive change to a currently approved collection
Documents and Forms
Document Name
Document Type
Attachment 1_Discussion Prompts_OMB_fnl 5.9.23.docx
Other-Survey
Attachment 1_Discussion Prompts_OMB_fnl 5.9.23.docx
Other-Survey
Insider Parent Consent Form_OMB_01.17.23_Remote Testing.docx
Parental Consent Form
IC Document
Insider Parent Consent Form_OMB_01.17.23_Remote Testing.docx
Parental Consent Form
IC Document
Insider Youth Assent Form__OMB_02-13-23_Remote Testing.docx
Youth Consent Form
IC Document
Insider Youth Assent Form__OMB_02-13-23_Remote Testing.docx
Youth Consent Form
IC Document
Fast-track-PRA-submission-short-form_OMB__Remote Testing_fnl 5.9.23.docx
Fast Track Submission Template
IC Document
Fast-track-PRA-submission-short-form_OMB__Remote Testing_fnl 5.9.23.docx
Fast Track Submission Template
IC Document
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Adolescent Development Products Feedback Survey and We Think Twice Digital Media Campaign
Agency IC Tracking Number:
FYSB
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
Other-Survey
Attachment 1_Discussion Prompts_OMB_fnl 5.9.23.docx
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Community and Social Services
Subfunction:
Social Services
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
70
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
4,200
0
0
0
0
4,200
Annual IC Time Burden (Hours)
1,386
0
0
0
0
1,386
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
Parental Consent Form
Insider Parent Consent Form_OMB_01.17.23_Remote Testing.docx
03/31/2023
Youth Consent Form
Insider Youth Assent Form__OMB_02-13-23_Remote Testing.docx
03/31/2023
Fast Track Submission Template
Fast-track-PRA-submission-short-form_OMB__Remote Testing_fnl 5.9.23.docx
05/11/2023
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.