Information Collection

Epidemiology Survey On Magnetic Effects On Human Health (questionnaire)

IC 135775 under ICR 198005-1901-001 · OMB 1901-0137.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type

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IC Title:

EPIDEMIOLOGY SURVEY ON MAGNETIC EFFECTS ON HUMAN HEALTH (QUESTIONNAIRE)

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Migrated

Obligation to Respond: Mandatory

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	XBG-504-510				No	No
Form	EV-443				No	No

Line of Business:

Subfunction:

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 2,200

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate
Annual Number of Responses for this IC	2,200	2,200
Annual IC Time Burden (Hours)	540	540
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.