Information Collection

DD - POST-ENROLLMENT F/U Phone Call Script

IC 224186 under ICR 202102-0920-008 · OMB 0920-1171.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Att 23.d. ThankYouLetter_DD Completion Letter _SEED 3_3-7-17.doc	Other-WORD
Att 23.d. ThankYouLetter_DD Completion Letter _SEED 3_3-7-17.doc	Other-WORD
Attachment 7.a. Pregnancy Reference Form Script SEED 3_9-19-16.doc	Other-WORD
Attachment 7.a. Pregnancy Reference Form Script SEED 3_9-19-16.doc	Other-WORD
Attachment 7.b. Pregnancy Reference Form SEED 3_9_19_16.docx	Other-WORD
Attachment 7.b. Pregnancy Reference Form SEED 3_9_19_16.docx	Other-WORD

IC Title:

Agency IC Tracking Number:

16PA

Is this a Common Form? No

IC Status: Unchanged

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Available Electronically?	Electronic Capability
Other-WORD	No	Paper Only
Other-WORD	No	Fillable Fileable
Other-WORD	No	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 158

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	Previously Approved
Annual Number of Responses for this IC	158	158
Annual IC Time Burden (Hours)	40	40
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.

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