Information Collection

Hazardous Substances Database (HSDB) Needs Assessment

IC 201530 under ICR 200906-0925-004 · OMB 0925-0476.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0925-0476 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1 Hazardous Substances Database (HSDB) Needs Assessment	Form and Instruction
1 Survey HSDB_Full Survey Screenshots[1].pdf	Form and Instruction
NLM Generic Clearance Request Form_HSDB NA_02 09 12[1].docx NLM Generic Clearance Request Form_HSDB NA_02 09 12[1]	IC Document
NLM Generic Clearance Mini Supporting Statement_HSDB NA[1].docx NLM Generic Clearance Mini Supporting Statement_HSDB NA[1]	IC Document

IC Title:

Hazardous Substances Database (HSDB) Needs Assessment

Agency IC Tracking Number:

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	1	Survey	HSDB_Full Survey Screenshots[1].pdf		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 150

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	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	150	0	0	0	0	0
Annual IC Time Burden (Hours)	50	0	0	0	0	0
Annual IC Cost Burden (Dollars)	0	0	0	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
NLM Generic Clearance Request Form_HSDB NA_02 09 12[1]	NLM Generic Clearance Request Form_HSDB NA_02 09 12[1].docx	03/01/2012
NLM Generic Clearance Mini Supporting Statement_HSDB NA[1]	NLM Generic Clearance Mini Supporting Statement_HSDB NA[1].docx	03/01/2012

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