EVALUATION OF STAFF TRAINING PROJECT/BLACK LUNG CLINIC PROGRAM

ICR 198103-0915-003

OMB: 0915-0019

Federal Form Document

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Document
Name
Status
No forms / supporting documents in this ICR. Check IC Document Collections.
IC Document Collections
ICR Details
0915-0019 198103-0915-003
Historical Active
HHS/HSA
EVALUATION OF STAFF TRAINING PROJECT/BLACK LUNG CLINIC PROGRAM
New collection (Request for a new OMB Control Number)   No
Regular
Approved without change 05/12/1981
Retrieve Notice of Action (NOA) 03/27/1981
  Inventory as of this Action Requested Previously Approved
06/30/1981 06/30/1981
90 0 0
40 0 0
0 0 0

THE INFORMATION TO BE GATHERED IS NECESSARY FOR THE COMPLETION OF A STAFF TRAINING PROJECT CONDUCTED FOR THE BLACK LUNG CLINIC PROGRAM UNDER A CONTRACT BY THE AMERICAN LUNG ASSOCIATION.

None
None


No

1
IC Title Form No. Form Name
EVALUATION OF STAFF TRAINING PROJECT/BLACK LUNG CLINIC PROGRAM

  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 90 0 0 90 0 0
Annual Time Burden (Hours) 40 0 0 40 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
No

$0
No
No
Uncollected
Uncollected
Uncollected
Uncollected

  No

On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
 
 
 
 
 
 
 
    (i) Why the information is being collected;
    (ii) Use of information;
    (iii) Burden estimate;
    (iv) Nature of response (voluntary, required for a benefit, or mandatory);
    (v) Nature and extent of confidentiality; and
    (vi) Need to display currently valid OMB control number;
 
 
 
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
03/27/1981


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