View Information Collection (IC)

View Information Collection (IC)

IC Title:	Pregnancy Probability Group Follow Up Script (PB, EH, TT-HI, TT-LI)	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	11.1	Survey	Pregnancy Probability Group Follow-Up - CATI Instrument 20110211.doc		Yes	Yes	Paper Only
Form and Instruction	11.2	Survey	Pregnancy Probability Group Follow-Up Instrument - SAQ 20110211.doc		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: 11,152	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	66,912	0	54,912	0	0	12,000
Annual IC Time Burden (Hours)	6,691	0	6,091	0	0	600
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.