Information Collection

Parent Interview (Groups 2 & 3) Interviewer's Guide

IC 205683 under ICR 201302-0920-003 · OMB unassigned.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Att 5 Parent Interview Guide--PG2--asymptomatic with sequelae.doc	Other-Interviewer's Guide for Childr
Att 6 Parent Interview Guide--PG3--symptomatic with or without sequelae.doc	Other-Interviewer's Guide for Childr

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

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
Other-Interviewer's Guide for Children Asymptomatic at Birth			Att 5 Parent Interview Guide--PG2--asymptomatic with sequelae.doc		No	No	Paper Only
Other-Interviewer's Guide for Children Symptomatic at Birth			Att 6 Parent Interview Guide--PG3--symptomatic with or without sequelae.doc		No	No	Paper Only

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 35

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Requested	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	35	35
Annual IC Time Burden (Hours)	35	35
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
No associated records found

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