Information Collection

BPCA Stakeholder Contact Details (NICHD)

IC 241871 under ICR 202301-0925-002 · OMB 0925-0766.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0925-0766 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1 BPCA Stakeholder Contact Details (NICHD)	Form and Instruction
Form 1 BPCA Stakeholder Contact Details (NICHD)	Form and Instruction
1 BPCA survey 0925-0766_Substudy_BPCA_survey.pdf	Form and Instruction
1 BPCA survey 0925-0766_Substudy_BPCA_survey.pdf	Form and Instruction
0225-0766_Substudy template_BPCA stakeholders.docx Sub-study template	IC Document
0225-0766_Substudy template_BPCA stakeholders.docx Sub-study template	IC Document
0925-0766_Substudy_BPCA_email solicitation.pdf BPCA email solicitation	IC Document
0925-0766_Substudy_BPCA_email solicitation.pdf BPCA email solicitation	IC Document
Privacy Act Memo.pdf Privacy Act Memo	IC Document
Privacy Act Memo.pdf Privacy Act Memo	IC Document

IC Title:

BPCA Stakeholder Contact Details (NICHD)

Agency IC Tracking Number:

IC Status: Unchanged

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	1	BPCA survey	0925-0766_Substudy_BPCA_survey.pdf		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 500

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Requested	Previously Approved
Annual Number of Responses for this IC	500	500
Annual IC Time Burden (Hours)	17	17
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Sub-study template	0225-0766_Substudy template_BPCA stakeholders.docx	05/19/2020
BPCA email solicitation	0925-0766_Substudy_BPCA_email solicitation.pdf	05/19/2020
Privacy Act Memo	Privacy Act Memo.pdf	05/19/2020

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.