Information Collection

Biospecimen Collection from Sentinel Cohort (Students and Household Members)

IC 214478 under ICR 201412-0920-016 · OMB 0920-1056.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Biospecimen Collection from Sentinel Cohort (Students and Household Members)	Form and Instruction
SMART2 Cohort Project Consent Form 23MAR2015 Attachment G SMART Cohort consent form.pdf	Form and Instruction

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
Form and Instruction	None	SMART2 Cohort Project Consent Form 23MAR2015	Attachment G SMART Cohort consent form.pdf	None	No		Paper Only

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title: 09-20-0160, Records of Subjects in Health Promotion and Eductaion Studie

FR Citation: 51 FR 42484

Number of Respondents: 1,440

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 Agency Discretion
Annual Number of Responses for this IC	1,440	1,440
Annual IC Time Burden (Hours)	120	120
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.