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Father Post-Natal Interview
Continuation of National Children's Study Vanguard (Pilot) Study Data Collection: Study Visits through 60-Months
OMB: 0925-0593
IC ID: 210037
OMB.report
HHS/NIH
OMB 0925-0593
ICR 201407-0925-005
IC 210037
( )
Documents and Forms
Document Name
Document Type
Form 45.1
Father Post-Natal Interview
Form and Instruction
45.1 Survey
FatherPostNatalQuestionnaireChild.docx
Form and Instruction
45.2 Survey
FatherPostNatalQuestionnaireAdult.docx
Form and Instruction
45.3 Survey
FatherPostNatalQuestionnaireHousehold.docx
Form and Instruction
Attach 13. Multi-Mode Visit Information Script.docx
MultiModeVisitInformationScript
IC Document
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Father Post-Natal Interview
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Modified
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
45.1
Survey
FatherPostNatalQuestionnaireChild.docx
Yes
Yes
Paper Only
Form and Instruction
45.2
Survey
FatherPostNatalQuestionnaireAdult.docx
Yes
Yes
Paper Only
Form and Instruction
45.3
Survey
FatherPostNatalQuestionnaireHousehold.docx
Yes
Yes
Paper Only
Federal Enterprise Architecture Business Reference Module
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:
558
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
558
0
0
0
0
558
Annual IC Time Burden (Hours)
149
0
0
0
0
149
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
MultiModeVisitInformationScript
Attach 13. Multi-Mode Visit Information Script.docx
07/24/2014
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.