EEOICPA Dose Reconstruction Interviews and Form

EEOICPA Dose Reconstruction Interviews and Form

OMB: 0920-0530

IC ID: 6981

Information Collection (IC) Details

View Information Collection (IC)

EEOICPA Dose Reconstruction Interviews and Form
 
No Modified
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction none Telephone Interview with Claimants and Coworkers Phone Interview with Revisions 12.09.doc No No Fillable Printable

Health Illness Prevention

09-20-0147 Occupational Health Epidemiological Studies and EEOICPA Program Records  68 FR 55962

4,200 0
   
Individuals or Households
 
   100 %

  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 4,200 0 0 0 0 4,200
Annual IC Time Burden (Hours) 4,200 0 0 0 0 4,200
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Proposed changes to interview forms Phone Interview with Proposed Revisions.doc 01/07/2010
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

© 2024 OMB.report | Privacy Policy