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Agenda
Reg Review
ICR
View Information Collection (IC)
View Information Collection (IC)
IC Title:
LOI2-QUEX-25-B, "National Children's Study Recruitment and Retention Network"
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
1
Screening Tool
Exemplar Screening Tool LOI2-QUEX-25 20110325.doc
No
No
Fillable Printable
Form and Instruction
2
Moderator's Guide
Exemplar_Moderator_Guide_LOI2-QUEX-25_20110405[1].docx
No
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:
30
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
240
0
0
0
0
0
Annual IC Time Burden (Hours)
240
0
0
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
Formative Research OMB Review Template LOI2-QUEX-25 20110331
Formative Research OMB Review Template LOI2-QUEX-25 20110331.docx
05/04/2011
Exemplar Informed Consent LOI2-QUEX-25 20110405
Exemplar Informed Consent LOI2-QUEX-25 20110405.docx
05/04/2011
NCS GC Cover Memorandum 20110331a
NCS GC Cover Memorandum 20110331a.docx
05/04/2011
Exemplar brochure
Exemplar Brochure LOI2-QUEX-25 20110526.pdf
05/26/2011
Exemplar Recruitment Letter
Exemplar Recruitment Letter LOI2-QUEX-25 20110526a.doc
05/26/2011
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.