Information Collection

18-Month Interview (PB, EH, TT-HI, TT-LI, PBS)

IC 193578 under ICR 201211-0925-001 · 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⚠️ Notice: This information collection may be referencing outdated material.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 23.1 18-Month Interview (PB, EH, TT-HI, TT-LI, PBS)	Form and Instruction
23.1 Survey 18-Month Interview 20120413.docx	Form and Instruction
23.4 Survey - Placeholder for copyrighted material 18 MO ASQ-3.docx	Form and Instruction
23.2 Survey - Placeholder for copyrighted material 14 MO ASQ-3.docx	Form and Instruction
23.3 Survey - Placeholder for copyrighted material 16 MO ASQ-3.docx	Form and Instruction
23.5 Survey - Placeholder for copyrighted material 20 MO ASQ-3.docx	Form and Instruction
23.6 Survey - Placeholder for copyrighted material 22 MO ASQ-3.docx	Form and Instruction
Note to File - 18 Month -- Administration of Ages and Stages 3 Questionnaire.docx Note to File - 18 Month ASQ Administration	IC Document

IC Title:

18-Month Interview (PB, EH, TT-HI, TT-LI, PBS)

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	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	23.1	Survey	18-Month Interview 20120413.docx	Yes	Yes	Paper Only
Form and Instruction	23.4	Survey - Placeholder for copyrighted material	18 MO ASQ-3.docx	Yes	Yes	Paper Only
Form and Instruction	23.2	Survey - Placeholder for copyrighted material	14 MO ASQ-3.docx	Yes	Yes	Paper Only
Form and Instruction	23.3	Survey - Placeholder for copyrighted material	16 MO ASQ-3.docx	Yes	Yes	Paper Only
Form and Instruction	23.5	Survey - Placeholder for copyrighted material	20 MO ASQ-3.docx	Yes	Yes	Paper Only
Form and Instruction	23.6	Survey - Placeholder for copyrighted material	22 MO ASQ-3.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: 1,316

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	1,316	1,316
Annual IC Time Burden (Hours)	658	658
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Note to File - 18 Month ASQ Administration	Note to File - 18 Month -- Administration of Ages and Stages 3 Questionnaire.docx	04/16/2012

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