Information Collection

SEED Blood Draw

IC 192884 under ICR 201005-0920-003 · OMB 0920-0741.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
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_R.2.1 Study Start Blood Draw form child (coversheet) 2007.doc	Other-WORD
Appendix_R.2.2 Study Start Blood Draw form adult (coversheet) 2007.doc	Other-WORD
Appendix_R.1 Biosample Shipping, Processing & Storage.doc Appendix_R	IC Document

IC Title:

SEED Blood Draw

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	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-WORD	Yes	Yes	Fillable Printable
Other-WORD	Yes	Yes	Fillable Printable
Other-WORD	Yes	No	Fillable Printable
Other-WORD	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: 966

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	966	966
Annual IC Time Burden (Hours)	242	242
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Appendix_R		04/27/2010

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

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