Information Collection

Adult-Focused Biospecimen Collection (Prenatal)

IC 193560 under ICR 201407-0925-005 · OMB 0925-0593.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1.1 Adult-Focused Biospecimen Collection (Prenatal)	Form and Instruction
1.1 Survey AdultBloodInstrument.docx	Form and Instruction
1.2 Survey AdultUrineInstrument.docx	Form and Instruction
1.4 Survey AdultBloodPreScreeningInstrument.docx	Form and Instruction
AdultUrineInstructions.doc AdultUrineInstructions	IC Document

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Unchanged

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	1.1	Survey	AdultBloodInstrument.docx	Yes	Yes	Paper Only
Form and Instruction	1.2	Survey	AdultUrineInstrument.docx	Yes	Yes	Paper Only
Form and Instruction	1.4	Survey	AdultBloodPreScreeningInstrument.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: 267

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	534	534
Annual IC Time Burden (Hours)	231	231
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
AdultUrineInstructions	AdultUrineInstructions.doc	11/07/2013

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