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DD- PRE-ENROLLMENT Invitation Packet/Response Card (Mother)
The Study to Explore Early Development (SEED) - Phase 3 (Modified for COVID-19 Impact Assessment)
OMB: 0920-1171
IC ID: 224182
OMB.report
HHS/CDC
OMB 0920-1171
ICR 202011-0920-014
IC 224182
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-1171 can be found here:
2021-02-18 - No material or nonsubstantive change to a currently approved collection
2020-12-08 - No material or nonsubstantive change to a currently approved collection
Documents and Forms
Document Name
Document Type
Att 19.b. Invitation Letter SEED Phase 3_DD_3-7-17.docx
Other-WORD
Att 19.g. Response Card SEED 3_3-7-17.docx
Other-WORD
Att 19.e. Study Brochure SEED 3_version DD_3-7-17.docx
Other-WORD
Attachment 9.e. CoverSheet_ADOS-2 Score Sheet Module-2 SEED-3_9_19_16.doc
Att 19g_Study Brochure
IC Document
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
DD- PRE-ENROLLMENT Invitation Packet/Response Card (Mother)
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Unchanged
Obligation to Respond:
Voluntary
CFR Citation:
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Other-WORD
Att 19.b. Invitation Letter SEED Phase 3_DD_3-7-17.docx
No
Paper Only
Other-WORD
Att 19.g. Response Card SEED 3_3-7-17.docx
No
Fillable Fileable
Other-WORD
Att 19.e. Study Brochure SEED 3_version DD_3-7-17.docx
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Public Health Monitoring
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
641
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
0 %
Requested
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
641
0
0
0
0
641
Annual IC Time Burden (Hours)
107
0
0
0
0
107
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
Att 19g_Study Brochure
Attachment 9.e. CoverSheet_ADOS-2 Score Sheet Module-2 SEED-3_9_19_16.doc
10/27/2016
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.