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Physical Activity Subsample Study
Continuation of National Children's Study Vanguard (Pilot) Study Data Collection: Study Visits through 60-Months
OMB: 0925-0593
IC ID: 210034
OMB.report
HHS/NIH
OMB 0925-0593
ICR 201407-0925-005
IC 210034
( )
Documents and Forms
Document Name
Document Type
Form 42.1
Physical Activity Subsample Study
Form and Instruction
PhysicalActivityGPSMonitorShippingInstructions.docx
Instruction
42.1 Survey
PhysicalActivityMonitorSAQ.docx
Form and Instruction
42.2 Survey
PhysicalActivityMonitorPickUpInstrument.docx
Form and Instruction
42.3 Survey
PhysicalActivityMonitorLogSAQ.docx
Form and Instruction
42.4 Survey
PhysicalActivityMonitorSetUpInstrument.docx
Form and Instruction
PhysicalActivityMonitorGPSInstructions.docx
PhysicalActivityMonitorGPSInstructions
IC Document
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Physical Activity Subsample Study
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Unchanged
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
42.1
Survey
PhysicalActivityMonitorSAQ.docx
Yes
Yes
Paper Only
Form and Instruction
42.2
Survey
PhysicalActivityMonitorPickUpInstrument.docx
Yes
Yes
Paper Only
Form and Instruction
42.3
Survey
PhysicalActivityMonitorLogSAQ.docx
Yes
Yes
Paper Only
Form and Instruction
42.4
Survey
PhysicalActivityMonitorSetUpInstrument.docx
Yes
Yes
Paper Only
Instruction
PhysicalActivityGPSMonitorShippingInstructions.docx
Yes
Yes
Paper Only
Federal Enterprise Architecture Business Reference Module
Line of Business:
General Science and Innovation
Subfunction:
Scientific and Technological Research and Innovation
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
200
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
0 %
Approved
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
600
0
0
0
0
600
Annual IC Time Burden (Hours)
430
0
0
0
0
430
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
PhysicalActivityMonitorGPSInstructions
PhysicalActivityMonitorGPSInstructions.docx
11/07/2013
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.