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Clinc/Home Visit - Saliva Collection (optional) Father
The Study to Explore Early Development (SEED) - Phase 3 (Modified for COVID-19 Impact Assessment)
OMB: 0920-1171
IC ID: 224166
OMB.report
HHS/CDC
OMB 0920-1171
ICR 202102-0920-008
IC 224166
( )
Documents and Forms
Document Name
Document Type
Attachment 16.b. Saliva Collection Instructions Form SEED 3.docx
Instruction
Attachment 16.b. Saliva Collection Instructions Form SEED 3.docx
Instruction
Attachment 16.c. Saliva Consent Form SEED 3.docx
Other-WORD
Attachment 16.c. Saliva Consent Form SEED 3.docx
Other-WORD
Attachment 16.d. Saliva Transmittal Form SEED 3_tmj8-25-17.doc
Other-WORD
Attachment 16.d. Saliva Transmittal Form SEED 3_tmj8-25-17.doc
Other-WORD
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Clinc/Home Visit - Saliva Collection (optional) Father
Agency IC Tracking Number:
16PA
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
Instruction
Attachment 16.b. Saliva Collection Instructions Form SEED 3.docx
No
Paper Only
Other-WORD
Attachment 16.c. Saliva Consent Form SEED 3.docx
No
Fillable Fileable
Other-WORD
Attachment 16.d. Saliva Transmittal Form SEED 3_tmj8-25-17.doc
No
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:
117
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
117
0
0
0
0
117
Annual IC Time Burden (Hours)
29
0
0
0
0
29
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.