Participant Verification & Tracing Interview

Continuation of National Children's Study Vanguard (Pilot) Study Data Collection: Study Visits through 60-Months

Documents and Forms

Document Name Document Type
Form 21.1 Participant Verification & Tracing Interview Form and Instruction
21.1 Survey ParticipantVerificationTracingQuestionnaire.docx Form and Instruction
PVTContactVerificationForm.docx PVTContactVerificationForm IC Document
PVTKeyDataVerificationForm.docx PVTKeyDataVerificationForm IC Document

Information Collection (IC) Details

IC Title:	Participant Verification & Tracing Interview	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	21.1	Survey	ParticipantVerificationTracingQuestionnaire.docx		Yes	Yes	Paper Only

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: 877	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	13,155	13,155
Annual IC Time Burden (Hours)	1,535	1,535
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
PVTContactVerificationForm	PVTContactVerificationForm.docx	11/08/2013
PVTKeyDataVerificationForm	PVTKeyDataVerificationForm.docx	11/08/2013

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.