PHYSICIAN'S EXAM

ICR 198112-1218-015

OMB: 1218-0063

Federal Form Document

Forms and Documents
Document
Name
Status
No forms / supporting documents in this ICR. Check IC Document Collections.
IC Document Collections
IC ID
Document
Title
Status
122550 Migrated
ICR Details
1218-0063 198112-1218-015
Historical Active
DOL/OSHA
PHYSICIAN'S EXAM
New collection (Request for a new OMB Control Number)   No
Regular
Approved without change 12/29/1981
Retrieve Notice of Action (NOA) 12/17/1981
  Inventory as of this Action Requested Previously Approved
04/30/1982 04/30/1982
292 0 0
219 0 0
0 0 0

THE PHYSICIANS' RECORD IS NEEDED TO ENSURE THAT AN EMPLOYEES' PHYSIOLOGICAL ABILITY TO FUNCTION IN A COMPRESSED AIR ENVIRONMENT CONTINUES WHILE ASSIGNED TO SUCH WORK.

None
None


No

1
IC Title Form No. Form Name
PHYSICIAN'S EXAM OSHA-234

  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 292 0 0 0 292 0
Annual Time Burden (Hours) 219 0 0 0 219 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
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.
12/17/1981


© 2024 OMB.report | Privacy Policy