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Enrollment Packet (DD)
The Study to Explore Early Development (SEED) - Phase 3 (Modified for COVID-19 Impact Assessment)
OMB: 0920-1171
IC ID: 224184
OMB.report
HHS/CDC
OMB 0920-1171
ICR 202011-0920-014
IC 224184
( )
⚠️ Notice: This information collection may be referencing outdated material.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
Attachment 11.b. Overall Consent _DD SEED 3_revised.doc
Other-WORD
Attachment 21.b. Invitation Call Script - DD source selection SEED 3_revised.docx
Other-WORD
Attachment 18. Participant Flow Chart_revised.docx
Att 18_ Study Flow Chart for Participant
IC Document
Att 20.b. Enrollment Packet Cover Letter DD SEED 3_3-7-17.docx
Att 20b_Enrollment Packet Cover Letter DD
IC Document
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Enrollment Packet (DD)
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
Attachment 11.b. Overall Consent _DD SEED 3_revised.doc
No
Fillable Fileable
Other-WORD
Attachment 21.b. Invitation Call Script - DD source selection SEED 3_revised.docx
No
Paper Only
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:
175
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
175
0
0
0
0
175
Annual IC Time Burden (Hours)
58
0
0
0
0
58
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
Att 18_ Study Flow Chart for Participant
Attachment 18. Participant Flow Chart_revised.docx
10/27/2016
Att 20b_Enrollment Packet Cover Letter DD
Att 20.b. Enrollment Packet Cover Letter DD SEED 3_3-7-17.docx
03/16/2017
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.