Information Collection

Application for Healthy Kids Challenge - Individual/Household

IC 192126 under ICR 201002-0584-002 · OMB 0584-0555.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0584-0555 can be found here:

Documents and Forms

Document Name Document Type
Screene-Shots for Challenge Wireframes.docx www.AppsforHealthyKids.com Other-Application

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Application for Healthy Kids Challenge - Individual/Household	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
Other-Application			Screene-Shots for Challenge Wireframes.docx	www.AppsforHealthyKids.com	Yes	Yes	Fillable Fileable Signable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 25	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	25	25
Annual IC Time Burden (Hours)	1,381	1,381
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.