Information Collection

Fathers

IC 184280 under ICR 200803-0925-005 · OMB 0925-0593.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0925-0593 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form A.2.2.c Fathers	Form and Instruction
A.2.3.f Survey A.2.3.f.2 Adult Urine Collection Form_Revised.doc	Form and Instruction
A.1.3.b Survey A.1.3.b T1 Father Interview_Revised.doc	Form and Instruction
A.2.2.a Survey A.2.2.a Father--Family Medical History.doc	Form and Instruction
A.2.2.b Survey A.2.2.b 6 month SAQ.doc	Form and Instruction
A.2.2.c Survey A.2.2.c 9 Month SAQ topics only.doc	Form and Instruction
A.2.2.d Survey A.2.2.d 12 month SAQ.doc	Form and Instruction
A.2.2.e Survey A.2.2.e 18 Month SAQ topics only.doc	Form and Instruction
A.2.3.b3 Survey A.2.3.b 3-T1 Dad Pre-Visit Instructions.doc	Form and Instruction
A.2.3.f Survey A.2.3.f.1 Urine Collection Instructions_Revised.doc	Form and Instruction
A.2.3.i Survey A.2.3.i 1-Nail Collection Instructions.doc	Form and Instruction
A.2.3.i Survey A.2.3.i 2-Nail Data Collection Form.doc	Form and Instruction
A.2.3.j1 Survey A.2.3.j Adult Saliva Collection_Revised.doc	Form and Instruction
A.2.3.j2 Survey A.2.3.j 2-Adult Saliva Data Collection Form Day 1.doc	Form and Instruction
A.2.3.j3 Survey A.2.3.j 3-Adult Saliva Data Collection Form Day 2.doc	Form and Instruction
A.2.3.L3 Survey A.2.3.l.3 Blood Draw Data Collection Form_Revised.doc	Form and Instruction
A.2.3.m1 Survey A.2.3.m.1 Adult Hair Data Collection Form.doc	Form and Instruction
A.3.1 Survey A.3.1 KBIT-2.doc	Form and Instruction
A.3.3 Survey A.3.3 Woodcock-Johnson III Test of Achievement.doc	Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:

Fathers

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	A.2.2.c	Survey	A.2.2.c 9 Month SAQ topics only.doc	Yes	Yes	Paper Only
Form and Instruction	A.2.2.e	Survey	A.2.2.e 18 Month SAQ topics only.doc	Yes	Yes	Paper Only
Form and Instruction	A.2.3.b3	Survey	A.2.3.b 3-T1 Dad Pre-Visit Instructions.doc	Yes	Yes	Paper Only
Form and Instruction	A.2.3.i	Survey	A.2.3.i 1-Nail Collection Instructions.doc	Yes	Yes	Paper Only
Form and Instruction	A.2.3.i	Survey	A.2.3.i 2-Nail Data Collection Form.doc	Yes	Yes	Paper Only
Form and Instruction	A.2.3.j2	Survey	A.2.3.j 2-Adult Saliva Data Collection Form Day 1.doc	Yes	Yes	Paper Only
Form and Instruction	A.2.3.j3	Survey	A.2.3.j 3-Adult Saliva Data Collection Form Day 2.doc	Yes	Yes	Paper Only
Form and Instruction	A.3.1	Survey	A.3.1 KBIT-2.doc	Yes	Yes	Paper Only
Form and Instruction	A.3.3	Survey	A.3.3 Woodcock-Johnson III Test of Achievement.doc	Yes	Yes	Paper Only
Form and Instruction	A.2.2.b	Survey	A.2.2.b 6 month SAQ.doc	Yes	Yes	Paper Only
Form and Instruction	A.2.3.L3	Survey	A.2.3.l.3 Blood Draw Data Collection Form_Revised.doc	Yes	Yes	Paper Only
Form and Instruction	A.2.2.d	Survey	A.2.2.d 12 month SAQ.doc	Yes	Yes	Paper Only
Form and Instruction	A.2.3.f	Survey	A.2.3.f.1 Urine Collection Instructions_Revised.doc	Yes	Yes	Paper Only
Form and Instruction	A.2.2.a	Survey	A.2.2.a Father--Family Medical History.doc	Yes	Yes	Paper Only
Form and Instruction	A.2.3.f	Survey	A.2.3.f.2 Adult Urine Collection Form_Revised.doc	Yes	Yes	Paper Only
Form and Instruction	A.2.3.j1	Survey	A.2.3.j Adult Saliva Collection_Revised.doc	Yes	Yes	Paper Only
Form and Instruction	A.2.3.m1	Survey	A.2.3.m.1 Adult Hair Data Collection Form.doc	Yes	Yes	Paper Only
Form and Instruction	A.1.3.b	Survey	A.1.3.b T1 Father Interview_Revised.doc	Yes	Yes	Paper Only

Federal Enterprise Architecture Business Reference Module

Line of Business: General Science and Innovation

Subfunction: Scientific and Technological Research and Innovation

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 954

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	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	1,908	1,908
Annual IC Time Burden (Hours)	1,374	1,374
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.