Information Collection

SEED- Care Giver Appendix B.2 , Appendix B.1

IC 178551 under ICR 200709-0920-004 · OMB 0920-0741.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0741 can be found here:

Documents and Forms

Document Name Document Type
Appendix B 2 Care Giver Interview.doc Instruction
Appendix B.1 Caregiver Interview Tel Script 2007 clean 06.doc Appendix B.1 Caregiver Tel script IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	SEED- Care Giver Appendix B.2 , Appendix B.1	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

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
Instruction			Appendix B 2 Care Giver Interview.doc		No	No	Fillable Printable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title: 09-20-0136 Epidemiologic Studies and Surveillance of Disease Problems	FR Citation: 57 FR 62812

Number of Respondents: 3,282	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Previously Approved
Annual Number of Responses for this IC	3,456	3,456
Annual IC Time Burden (Hours)	3,456	3,456
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Appendix B.1 Caregiver Tel script	Appendix B.1 Caregiver Interview Tel Script 2007 clean 06.doc	09/11/2007

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.