Information Collection

Chronic Hazard Advisory Panel Questionnaire

IC 189155 under ICR 200905-3041-001 · OMB 3041-0139.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 0 Chronic Hazard Advisory Panel Questionnaire	Form and Instruction
0 Chronic Hazard Advisory Panel Questionnaire OMB_New_CHAP_Letter_Questionnaire.pdf	Form and Instruction
SOR FR Notice.PDF System of Records Notice	IC Document

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	0	Chronic Hazard Advisory Panel Questionnaire	OMB_New_CHAP_Letter_Questionnaire.pdf		No		Paper Only

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records

Title: CPSC-2 Advisory Committee Records

FR Citation: 63 FR 250

Number of Respondents: 27

Number of Respondents for Small Entity: 27

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	27	27
Annual IC Time Burden (Hours)	27	27
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
System of Records Notice	SOR FR Notice.PDF	05/14/2009

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.