Information Collection

Healthy Native Babies Project Materials Distribution

IC 213751 under ICR 201403-0925-009 · OMB 0925-0701.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0925-0701 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1 Healthy Native Babies Project Materials Distribution	Form and Instruction
1 Tracking Form Attachment 2_0925-0701_Healthy Native Babies Materials Distribution Tracking Form.DOC	Form and Instruction
0925-0701_Generic ICR_Healthy Native Babies Materials Distribution_rev 10-28-14.doc Generic Clearance Form Healthy Native Babies Project Materials Distribution	IC Document
0925-0701_Sub-study Memo_Healthy Native Babies Materials Distribution_rev 10-28-14.docx Cover Memo Healthy Native Babies Project Materials Distribution	IC Document

IC Title:

Healthy Native Babies Project Materials Distribution

Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Mandatory

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	1	Tracking Form	Attachment 2_0925-0701_Healthy Native Babies Materials Distribution Tracking Form.DOC		No		Paper Only

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 6

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	6	6
Annual IC Time Burden (Hours)	3	3
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Generic Clearance Form Healthy Native Babies Project Materials Distribution	0925-0701_Generic ICR_Healthy Native Babies Materials Distribution_rev 10-28-14.doc	11/10/2014
Cover Memo Healthy Native Babies Project Materials Distribution	0925-0701_Sub-study Memo_Healthy Native Babies Materials Distribution_rev 10-28-14.docx	11/10/2014

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