Information Collection

Childbirth and Breastfeeding Demonstration Survey

IC 251890 under ICR 202509-0720-003 · OMB 0720-0070.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
0720-0070_Survey Instrument_6.5.2025.docx	Other-Survey
0720-0070_Survey Instrument_3.6.2026.docx	Other-Survey

IC Title:

Agency IC Tracking Number:

0720-0070

Is this a Common Form? No

IC Status: Modified

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
Other-Survey					Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 5,925

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	5,925	5,925
Annual IC Time Burden (Hours)	988	988
Annual IC Cost Burden (Dollars)	31,106	31,106

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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