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Second Parents
The Healthy Communities Study: How Communities Shape Childrens Health (NHLBI)
OMB: 0925-0649
IC ID: 199546
OMB.report
HHS/NIH
OMB 0925-0649
ICR 201302-0925-008
IC 199546
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0925-0649 can be found here:
2013-07-24 - Revision of a currently approved collection
Documents and Forms
Document Name
Document Type
Form 3
Second Parents
Form and Instruction
3 Family Household Visit Protocol Overview
FINAL_HCS_SSA_ATTACH 7_2ND PARENT PROTOCOL_Jan 2013 v2.docx
Form and Instruction
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Second Parents
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Modified
Obligation to Respond:
Required to Obtain or Retain Benefits
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
3
Family Household Visit Protocol Overview
FINAL_HCS_SSA_ATTACH 7_2ND PARENT PROTOCOL_Jan 2013 v2.docx
No
No
Paper Only
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Health Care Services
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
3,564
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
0 %
Requested
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
3,564
0
0
171
0
3,393
Annual IC Time Burden (Hours)
416
0
0
9
0
407
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.