Information Collection

LOI3-RT-01-N GC/MS methods to determine environmental factors on fetal and newborn gene expression

IC 204811 under ICR 201109-0925-001 · OMB 0925-0647.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Attach 5. LOI3-RT-01-N - IRB Protocol.pdf	Instruction
Attach 1. LOI-3-RT-01-N - Recruitment Script new.docx	Instruction
LOI3-RT-01-N - OIRA Template 20121016.docx LOI3-RT-01-N-OIRA Template	IC Document
Attach 3. LOI3-RT-01-N - IRB Approval.pdf LOI3-RT-01-N- IRB Approval	IC Document
Attach 4. LOI3-RT-01-N - IRB Continuation Approval.pdf LOI3-RT-01-N- IRB Continuation Approval	IC Document
Attach 2. LOI3-RT-01-N - Exemplar Consent Form new.docx Consent	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
Instruction			Attach 5. LOI3-RT-01-N - IRB Protocol.pdf		Yes	Yes	Paper Only
Instruction			Attach 1. LOI-3-RT-01-N - Recruitment Script new.docx		No		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: 900

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	1,300	0	0	0	0	0
Annual IC Time Burden (Hours)	150	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
LOI3-RT-01-N-OIRA Template	LOI3-RT-01-N - OIRA Template 20121016.docx	10/16/2012
LOI3-RT-01-N- IRB Approval	Attach 3. LOI3-RT-01-N - IRB Approval.pdf	10/16/2012
LOI3-RT-01-N- IRB Continuation Approval	Attach 4. LOI3-RT-01-N - IRB Continuation Approval.pdf	10/16/2012
Consent	Attach 2. LOI3-RT-01-N - Exemplar Consent Form new.docx	12/28/2012

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