ENROLLMENT Packet (Mother)

The Study to Explore Early Development (SEED) - Phase 3 (Modified for COVID-19 Impact Assessment)

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-1171 can be found here:

Documents and Forms

Document Name Document Type
Att 20.a. Enrollment Packet Cover Letter ASD and POP SEED 3_3-7-17.docx Other-WORD
Attachment 20.c. Bill of rights SEED 3.doc Instruction
Attachment 18. Participant Flow Chart_revised.docx Other-WORD
Attachment 11.c. Overall Consent _POP SEED 3_revised.doc Other-WORD

Information Collection (IC) Details

IC Title:	ENROLLMENT Packet (Mother)	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Unchanged

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Instrument File	Available Electronically?	Electronic Capability
Other-WORD	Att 20.a. Enrollment Packet Cover Letter ASD and POP SEED 3_3-7-17.docx	No	Paper Only
Instruction	Attachment 20.c. Bill of rights SEED 3.doc	No	Paper Only
Other-WORD	Attachment 18. Participant Flow Chart_revised.docx	No	Paper Only
Other-WORD	Attachment 11.c. Overall Consent _POP SEED 3_revised.doc	No	Fillable Fileable Signable

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: 334	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Previously Approved
Annual Number of Responses for this IC	334	334
Annual IC Time Burden (Hours)	111	111
Annual IC Cost Burden (Dollars)	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.