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Contents Of A Request For Health Hazard Evaluation, Regulation -- 42 Cfr 85.3-1
CONTENTS OF A REQUEST FOR HEALTH HAZARD EVALUATION, REGULATION -- 42 CFR 85.3-1
OMB: 0920-0102
IC ID: 110696
OMB.report
HHS/CDC
OMB 0920-0102
ICR 199208-0920-003
IC 110696
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0102 can be found here:
2001-12-04 - Extension without change of a currently approved collection
1998-08-17 - Extension without change of a currently approved collection
Documents and Forms
Document Name
Document Type
no available documents/forms check other ICs listed under this ICR
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
CONTENTS OF A REQUEST FOR HEALTH HAZARD EVALUATION, REGULATION -- 42 CFR 85.3-1
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Migrated
Obligation to Respond:
Required to Obtain or Retain Benefits
CFR Citation:
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form
CDC/NIOSH
No
No
Form
2.86
No
No
Federal Enterprise Architecture Business Reference Module
Line of Business:
Subfunction:
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
500
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
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
500
0
0
0
0
500
Annual IC Time Burden (Hours)
100
0
0
0
0
100
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.