Information Collection

SEED - Biosamples

IC 178556 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⚠️ Notice: This information collection may be referencing outdated material.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

Documents and forms in this information collection
Document Name	Document Type
Form No number Appendix E.21 Buccal Transmittal Form SEED - Biosamples	Form and Instruction
Form No number Appendix R.20 Buccal IC bioMom SEED - Biosamples	Form and Instruction
Form No number Appendix E.20 Buccal IC bio Dad SEED - Biosamples	Form and Instruction
Form No number Appendix R.2 Blood Draw Form SEED - Biosamples	Form and Instruction
Form No number Appendix E.19 How to Collect Cheek Cell SEED - Biosamples	Form and Instruction
No number Appendix R.20 Buccal IC bioMom Appendix E.20 Buccal Consent Mom 2007 06.doc	Form and Instruction
No number Appendix E.20 Buccal IC bio Dad Appendix E.20 Buccal IC bioDad.doc	Form and Instruction
No number Appendix E.21 Buccal Transmittal Form Appendix E.21 Buccal Transmittal Form 2007 06.doc	Form and Instruction
No number Appendix R.2 Blood Draw Form Appendix R.2 Blood Draw form.pdf	Form and Instruction
No number Appendix E.19 How to Collect Cheek Cell Appendix E.19 Buccal Swab Instructions 2007 06.doc	Form and Instruction

IC Title:

SEED - Biosamples

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	No number	Yes	Yes	Fillable Printable
Form and Instruction	No number	Yes	Yes	Fillable Printable
Form and Instruction	No number	Yes	Yes	Fillable Printable
Form and Instruction	No number	Yes	Yes	Fillable Printable
Form and Instruction	No number	Yes	Yes	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: 3,456

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	30,078	30,078
Annual IC Time Burden (Hours)	12,362	12,362
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
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.

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