Male time to pregnancy journal

Longitudinal Investigation of Fertility and the Environment

Documents and Forms

Document Name Document Type
Form 1g Male time to pregnancy journal Form and Instruction
1g Survey Attachment 1.g. Male Time to Pregnancy Journal.pdf Form and Instruction

Information Collection (IC) Details

IC Title:	Male time to pregnancy journal	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

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	1g	Survey	Attachment 1.g. Male Time to Pregnancy Journal.pdf		Yes	Yes	Paper Only

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 500	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 30 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	500	500
Annual IC Time Burden (Hours)	15	15
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.