EEOICPA Special Exposure Cohort Petition Forms (42 CFR Part 8)

EEOICPA Special Exposure Cohort Petition Forms (42 CFR Part 8)

OMB: 0920-0639

IC ID: 180183

Information Collection (IC) Details

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EEOICPA Special Exposure Cohort Petition Forms (42 CFR Part 8)
 
No New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form 83.9 Special Exposure Cohort Petition Form B Attachment E - Instructions for Form B SEC.pdf Yes Yes Printable Only

Health Illness Prevention

 

40 0
   
Individuals or Households
 
   10 %

  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 40 0 40 0 0 0
Annual IC Time Burden (Hours) 200 0 200 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Instructions for Form B Attachment E - Instructions for Form B SEC.pdf 05/04/2007
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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