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Vanguard Specimen and Data Request Form
National Children's Study (NCS) Vanguard Data and Sample Archive and Access System (NICHD)
OMB: 0925-0730
IC ID: 220004
OMB.report
HHS/NIH
OMB 0925-0730
ICR 201508-0925-002
IC 220004
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0925-0730 can be found here:
2019-02-06 - Extension without change of a currently approved collection
Documents and Forms
Document Name
Document Type
Form 3
Vanguard Specimen and Data Request Form
Form and Instruction
3 Vanguard Specimen and Data Request Form
Attachment A.3 Vanguard Specimen and Data Request Form_02-04-2016_MARKED.docx
Form and Instruction
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Vanguard Specimen and Data Request Form
Agency IC Tracking Number:
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
3
Vanguard Specimen and Data Request Form
Attachment A.3 Vanguard Specimen and Data Request Form_02-04-2016_MARKED.docx
Yes
Yes
Fillable Fileable
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:
50
Number of Respondents for Small Entity:
0
Affected Public:
Private Sector
Private Sector:
Not-for-profit institutions
Percentage of Respondents Reporting Electronically:
100 %
Requested
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
50
0
50
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.