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ENROLLMENT Packet (Mother)
The Study to Explore Early Development (SEED) - Phase 3 (Modified for COVID-19 Impact Assessment)
OMB: 0920-1171
IC ID: 224022
OMB.report
HHS/CDC
OMB 0920-1171
ICR 202102-0920-008
IC 224022
( )
Documents and Forms
Document Name
Document Type
Att 20.a. Enrollment Packet Cover Letter ASD and POP SEED 3_3-7-17.docx
Other-WORD
Att 20.a. Enrollment Packet Cover Letter ASD and POP SEED 3_3-7-17.docx
Other-WORD
Attachment 20.c. Bill of rights SEED 3.doc
Instruction
Attachment 20.c. Bill of rights SEED 3.doc
Instruction
Attachment 18. Participant Flow Chart_revised.docx
Other-WORD
Attachment 18. Participant Flow Chart_revised.docx
Other-WORD
Attachment 11.c. Overall Consent _POP SEED 3_revised.doc
Other-WORD
Attachment 11.c. Overall Consent _POP SEED 3_revised.doc
Other-WORD
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
ENROLLMENT Packet (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 20.a. Enrollment Packet Cover Letter ASD and POP SEED 3_3-7-17.docx
No
Paper Only
Instruction
Attachment 20.c. Bill of rights SEED 3.doc
No
Paper Only
Other-WORD
Attachment 18. Participant Flow Chart_revised.docx
No
Paper Only
Other-WORD
Attachment 11.c. Overall Consent _POP SEED 3_revised.doc
No
Fillable Fileable Signable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Public Health Monitoring
Privacy Act System of Records
Title:
09-20-0136: Epidemiologic Studies and Surveillance of Disease Problems
FR Citation:
57 FR 62812
Number of Respondents:
334
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
0 %
Approved
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
334
0
0
0
0
334
Annual IC Time Burden (Hours)
111
0
0
0
0
111
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
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.