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ASD - PRE-ENROLLMENT_Invitation Packet/Response Card (Mother)
The Study to Explore Early Development (SEED) - Phase 3 (Modified for COVID-19 Impact Assessment)
OMB: 0920-1171
IC ID: 224009
OMB.report
HHS/CDC
OMB 0920-1171
ICR 202012-0920-003
IC 224009
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-1171 can be found here:
2021-02-18 - No material or nonsubstantive change to a currently approved collection
Documents and Forms
Document Name
Document Type
Attachment 19.a. Invitation Letter SEED Phase 3_ ASD.docx
Other-WORD
Attachment 19.g. Response Card SEED 3.docx
Other-WORD
Attachment 19.d. Study Brochure SEED 3_version ASD_revised 9-15-16.docx
Other-WORD
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
ASD - PRE-ENROLLMENT_Invitation Packet/Response Card (Mother)
Agency IC Tracking Number:
16PA
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
Other-WORD
Attachment 19.a. Invitation Letter SEED Phase 3_ ASD.docx
No
Paper Only
Other-WORD
Attachment 19.g. Response Card SEED 3.docx
No
Fillable Printable
Other-WORD
Attachment 19.d. Study Brochure SEED 3_version ASD_revised 9-15-16.docx
No
Paper Only
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Public Health Monitoring
Privacy Act System of Records
Title:
09-20-0136: Epidemiologic Studies and Surveillance of Disease Problems
FR Citation:
57 FR 62812
Number of Respondents:
1,718
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
1,718
0
0
0
0
1,718
Annual IC Time Burden (Hours)
286
0
0
0
0
286
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.