Information Collection

Birth Visit Interview (PB, EH, TT-HI)

IC 193570 under ICR 201107-0925-001 · OMB 0925-0593.

⚠️ Notice: This information collection may be referencing outdated material.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

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 20.1 Birth Visit Interview (PB, EH, TT-HI)	Form and Instruction
20.1 Survey Birth Visit Interview 20110211.docx	Form and Instruction
Note to File - Birth Visit - Umbilical Cord Blood Collection.docx Note to File - Birth Visit - Umbilical Cord Blood Collection	IC Document

IC Title:

Birth Visit Interview (PB, EH, TT-HI)

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	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	20.1	Survey	Birth Visit Interview 20110211.docx		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: 2,672

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	Previously Approved
Annual Number of Responses for this IC	2,672	2,672
Annual IC Time Burden (Hours)	1,069	1,069
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Note to File - Birth Visit - Umbilical Cord Blood Collection	Note to File - Birth Visit - Umbilical Cord Blood Collection.docx	04/08/2011

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