Information Collection

Healthy Native Babies Post-training Survey

IC 194799 under ICR 201010-0925-001 · OMB 0925-0532.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1 Healthy Native Babies Post-training Survey	Form and Instruction
1 survey HNB Post Training Survey_08.20.10.pdf	Form and Instruction
Healthy Native Babies Post-training Survey_Memo (2).docx Healthy Native Babies Post-training Survey_Memo (2)	IC Document
ClearanceForm_HNB Survey _NICHD OMB 0925-0532 (2).docx ClearanceForm_HNB Survey _NICHD OMB 0925-0532 (2)	IC Document

IC Title:

Agency IC Tracking Number:

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	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	1	survey	HNB Post Training Survey_08.20.10.pdf		No	No	Paper Only

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 152

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 New Statute	Program Change Due to Agency Discretion	Change Due to Adjustment in Agency Estimate	Change Due to Potential Violation of the PRA	Previously Approved
Annual Number of Responses for this IC	152	0	0	0	0	0
Annual IC Time Burden (Hours)	26	0	0	0	0	0
Annual IC Cost Burden (Dollars)	0	0	0	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Healthy Native Babies Post-training Survey_Memo (2)	Healthy Native Babies Post-training Survey_Memo (2).docx	09/08/2010
ClearanceForm_HNB Survey _NICHD OMB 0925-0532 (2)	ClearanceForm_HNB Survey _NICHD OMB 0925-0532 (2).docx	09/08/2010

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