Information Collection

Arctic Intro to FASD Pre-test

IC 204212 under ICR 201209-0920-008 · OMB 0920-0954.

Documents and Forms

Document Name Document Type
Arctic Intro to FASD Pre-test Form
Intro to FASD Pre-test Att C7 Arctic RTC - Intro to FASDs Pre.docx Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Arctic Intro to FASD Pre-test	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	none	Intro to FASD Pre-test	Att C7 Arctic RTC - Intro to FASDs Pre.docx		No	No	Paper Only

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 80	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	80	80
Annual IC Time Burden (Hours)	20	20
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.