Supplemental CATI about Stillbirth

[NCBDDD] Birth Defects Study to Evaluate Pregnancy exposureS (BD-STEPS)

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0010 can be found here:

Documents and Forms

Document Name Document Type
Supplemental CATI about Stillbirth Form and Instruction
Computer Assisted Phone Interview about Stillbirth (Engl AttG1a_Supplemental_CATI.docx Form and Instruction
Computer Assisted Phone Interview about Stillbirth (Engl AttG1a_Supplemental_CATI.docx Form and Instruction
Computer Assisted Phone Interview about Stillbirth (Span AttG1b_Supplemental_CATI.docx Form and Instruction
Computer Assisted Phone Interview about Stillbirth (Span AttG1b_Supplemental_CATI.docx Form and Instruction

Information Collection (IC) Details

IC Title:	Supplemental CATI about Stillbirth	Agency IC Tracking Number:	0920-0010

Is this a Common Form? No		IC Status: Modified

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
Form and Instruction	n/a	Computer Assisted Phone Interview about Stillbirth (English)	AttG1a_Supplemental_CATI.docx		Yes	Yes	Fillable Fileable
Form and Instruction	n/a	Computer Assisted Phone Interview about Stillbirth (Spanish)	AttG1b_Supplemental_CATI.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title: Epidemiologic Studies and Surveillance of Disease Problems	FR Citation: 57 FR 62812

Number of Respondents: 640	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	640	0	640
Annual IC Time Burden (Hours)	267	0	267
Annual IC Cost Burden (Dollars)	0	-2,667	2,667

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.