Information Collection

SEED - Biosamples (cheek swab and blood)

IC 178556 under ICR 201005-0920-003 · OMB 0920-0741.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Appendix_E.20 Study Start Buccal Consent Dad 2007.doc	Other-WORD
Appendix_E.21 Study Start Cheek Swab Record Sheet 2007 .doc	Other-WORD
Appendix_E 20.1 Informed Consent From Check Swab for Biological Mother and Child Participant.doc	Other-WORD
Appendix_R.2 Study Start Blood Draw form adult 2007.doc	Other-WORD
Appendix_R.2 Study Start Blood Draw form child 2007.doc	Other-WORD
Appendix_E.19 Study Start How to collect Cheek Swab 2007.doc Appendix_E	IC Document
Appendix_R.1 Biosample Shipping, Processing & Storage.doc Appendix_R	IC Document
Appendix_E.7 Study Start Frequently Asked Questions on Biosampling 2007 .doc Appendix_E	IC Document

IC Title:

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	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-WORD	Appendix_E.20 Study Start Buccal Consent Dad 2007.doc	Yes	Yes	Fillable Printable
Other-WORD	Appendix_E.21 Study Start Cheek Swab Record Sheet 2007 .doc	Yes	Yes	Fillable Printable
Other-WORD	Appendix_E 20.1 Informed Consent From Check Swab for Biological Mother and Child Participant.doc	Yes	Yes	Fillable Printable
Other-WORD	Appendix_R.2 Study Start Blood Draw form adult 2007.doc	Yes	Yes	Fillable Printable
Other-WORD	Appendix_R.2 Study Start Blood Draw form child 2007.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: 1,041

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	Previously Approved
Annual Number of Responses for this IC	1,041	-29,037	30,078
Annual IC Time Burden (Hours)	694	-11,668	12,362
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Appendix_E	Appendix_E.19 Study Start How to collect Cheek Swab 2007.doc	04/15/2010
Appendix_R	Appendix_R.1 Biosample Shipping, Processing & Storage.doc	04/15/2010
Appendix_E	Appendix_E.7 Study Start Frequently Asked Questions on Biosampling 2007 .doc	04/26/2010

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