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Federal forms, ICRs, and supporting documents

Information Collection

Time / Activity Form - for Mothers / Primary Caregivers

IC 198577 under ICR 201408-0920-008 · OMB 0920-0906.

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Time / Activity Form - for Mothers / Primary Caregivers
 
No Modified
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form N/A REVISED_APPENDIX_D11_Time Activity (Mother- Primary Caregiver)_October 20.2011 REVISED_APPENDIX_D11_Time Activity (Mother- Primary Caregiver)_October 20.2011.doc No No Paper Only

Health Immunization Management

Epidemiological Studies and Surveillance of Disease Problems 09-20-0136  57 FR 62812

832 0
   
Individuals or Households
 
   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 3,328 0 0 0 0 3,328
Annual IC Time Burden (Hours) 277 0 0 0 0 277
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Time/Activity - mothers - Chinese Time Activity(Mother- Primary Caregiver) Chinese version - November 30, 2011.doc 12/14/2011
Time/Activity - mothers - Spanish Time Activity (Mother- Primary Caregiver) SPANISH - November 30, 2011.doc 12/14/2011
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.