Information Collection

Refresher Course Application

IC 184871 under ICR 201107-0920-003 · OMB 0920-0138.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0138 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 4 Refresher Course Application	Form and Instruction
4 NIOSH-Approved Spirometry Refresher Course Application Attachment F NIOSH-Approved Spirometry Refresher Course Application a (2).doc	Form and Instruction

IC Title:

Refresher Course Application

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

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	4	NIOSH-Approved Spirometry Refresher Course Application	Attachment F NIOSH-Approved Spirometry Refresher Course Application a (2).doc		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Illness Prevention

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 10

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	10	10
Annual IC Time Burden (Hours)	80	80
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
No associated records found

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