OMB
.report
Search
Urine specimen
Longitudinal Investigation of Fertility and the Environment
OMB: 0925-0543
IC ID: 184318
OMB.report
HHS/NIH
OMB 0925-0543
ICR 200803-0925-006
IC 184318
( )
Documents and Forms
Document Name
Document Type
Form 1.o
Urine specimen
Form and Instruction
1.o Survey
Attachment 1.o. Urine Specimen Information Sheet.pdf
Form and Instruction
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Urine specimen
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
1.o
Survey
Attachment 1.o. Urine Specimen Information Sheet.pdf
Yes
Yes
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:
500
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
100 %
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
500
0
500
0
0
0
Annual IC Time Burden (Hours)
25
0
25
0
0
0
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.