INTERIM PROCEDURES FOR REQUESTING HEALTH ASSESSMENTS

ICR 198709-0920-001

OMB: 0920-0204

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
110856
Migrated
ICR Details
0920-0204 198709-0920-001
Historical Active
HHS/CDC
INTERIM PROCEDURES FOR REQUESTING HEALTH ASSESSMENTS
New collection (Request for a new OMB Control Number)   No
Regular
Approved without change 11/03/1987
Retrieve Notice of Action (NOA) 09/08/1987
  Inventory as of this Action Requested Previously Approved
11/30/1990 11/30/1990
100 0 0
50 0 0
0 0 0

THE AGENCY FOR TOXIC SUBSTANCES AND DISEASE REGISTRY IS AUTHORIZED TO PERFORM HEALTH ASSESSMENTS WHERE INDIVIDUALS HAVE BEEN EXPOSED TO A HAZARDOUS SUBSTANCE. THIS DATA COLLECTION (TO BE PUBLISHED IN THE FEDERAL REGISTER) DESCRIBES PROCEDURES BY WHICH THE PUBLIC MAY REQUEST ATSDR TO CONDUCT HEALTH ASSESSMENTS.

None
None


No

1
IC Title Form No. Form Name
INTERIM PROCEDURES FOR REQUESTING HEALTH ASSESSMENTS

  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 100 0 0 100 0 0
Annual Time Burden (Hours) 50 0 0 50 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.
09/08/1987


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