Information Collection

SEED- Clinic Visit - Control Parent

IC 178553 under ICR 201005-0920-003 · OMB 0920-0741.

Documents and Forms

Document Name Document Type
Appendix_F.4 Vineland.pdf Other-WORD
Appendix_E.3 Study Start Informed Consent NIC- Sub 2007.doc Appendix_E IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	SEED- Clinic Visit - Control Parent	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
Other-WORD			Appendix_F.4 Vineland.pdf		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: 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	Previously Approved
Annual Number of Responses for this IC	80	-2,234	2,314
Annual IC Time Burden (Hours)	60	-332	392
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

Title	Document	Date Uploaded
Appendix_E	Appendix_E.3 Study Start Informed Consent NIC- Sub 2007.doc	04/26/2010

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