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ICR
View Information Collection (IC)
View Information Collection (IC)
IC Title:
First Follow-up Core Survey of SEED 1-3 Caregivers
Agency IC Tracking Number:
0920-25-0027
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
0920
SEED Follow-Up Health and Development Core Survey
Att 2f-h - First Follow-up Core Survey of SEED 1-3 Caregivers.pdf
No
Fillable Fileable
Other-Script
Att 2c - Enrollment Call Script and Consent 1st Survey.docx
No
Paper Only
Form and Instruction
n/a
SEED Follow-Up Health and Development Core Survey - Spanish
Att 2f_S - First Follow-up Core Survey of SEED 1-3 Caregivers_Spanish_final.docx
No
Fillable Fileable
Form
0920-25-0027
SEED Follow-up Core Survey (2f)
Attachment 2f - SEED Follow-Up Health and Development Core Survey_02-03-25_tracked_changes.docx
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Public Health Monitoring
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
1,234
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
1,234
0
0
0
0
1,234
Annual IC Time Burden (Hours)
823
0
0
0
0
823
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
Invitation Letter 1st Survey
Att 2a - Invitation Letter 1st Survey.docx
09/12/2022
Response Card 1st Survey
Att 2b - Response Card 1st Survey.docx
09/12/2022
Participant Information Sheet
Att 2d - Participant Information Sheet for SEED 1-3 Caregivers_3-28-22.docx
09/12/2022
Consent for Genetic Data Sharing
Att 2e - Consent Form for Genetic Data Sharing.docx
09/12/2022
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.