Enhanced Household: 12-Month Visit Interview

Recruitment Strategy Substudy for the National Children's Study (NICHD)

⚠️ Notice: This information collection may be referencing outdated material.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

Documents and Forms

Document Name Document Type
Form 61.1 Enhanced Household: 12-Month Visit Interview Form and Instruction
61.1 Survey 12-Month Mother Interview 20110211.docx Form and Instruction
61.2 Survey 12-Month Mother SAQ 20110211.doc Form and Instruction
12-Month Visit Information Sheet 20110211.docx 12-Month Visit Information Sheet 20110211 IC Document

Information Collection (IC) Details

IC Title:	Enhanced Household: 12-Month Visit Interview	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

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
Form and Instruction	61.1	Survey	12-Month Mother Interview 20110211.docx		Yes	Yes	Paper Only
Form and Instruction	61.2	Survey	12-Month Mother SAQ 20110211.doc		Yes	Yes	Paper Only

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: 457	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Requested	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	457	457
Annual IC Time Burden (Hours)	229	229
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
12-Month Visit Information Sheet 20110211	12-Month Visit Information Sheet 20110211.docx	02/11/2011

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