Non Response Statement

Childhood Injury and Adult Occupational Injury Survey

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0535-0235 can be found here:

Documents and Forms

Document Name Document Type
Non_Response_Reply.doc Other-Non Response Statement

Information Collection (IC) Details

IC Title:	Non Response Statement	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Non Response Statement			Non_Response_Reply.doc		No		Paper Only

Line of Business: Economic Development

Subfunction: Industry Sector Income Stabilization

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 5,000	Number of Respondents for Small Entity: 4,250

Affected Public: Private Sector	Private Sector: Farms

Percentage of Respondents Reporting Electronically: 0 %

	Requested	Program Change Due to Agency Discretion	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	5,000	-5,100	-20,000	30,100
Annual IC Time Burden (Hours)	333	-338	0	671
Annual IC Cost Burden (Dollars)	0	0	0	0

Documents for IC

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.