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⚠️ Notice: This information collection may be referencing outdated material.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
Form QID Childhood Injury and Adult Occupational Injury Survey Form and Instruction
QID All - Terrain Vehicle Prevlance and Injury Questionnaire 0235 - ATV 2012 Questionnaire.docx Form and Instruction
QID Childhood Injury and Adult Occupational Injury Questionn 0235 - 2008 NIOSH CIAOI Questionnarie.doc Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Childhood Injury and Adult Occupational Injury Survey	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
Form and Instruction	QID	All - Terrain Vehicle Prevlance and Injury Questionnaire	0235 - ATV 2012 Questionnaire.docx		No		Paper Only
Form and Instruction	QID	Childhood Injury and Adult Occupational Injury Questionnaire	0235 - 2008 NIOSH CIAOI Questionnarie.doc		No		Paper Only

Line of Business: Economic Development

Subfunction: Industry Sector Income Stabilization

Privacy Act System of Records
Title: SORN	FR Citation: 74 FR 79

Number of Respondents: 20,000	Number of Respondents for Small Entity: 17,000

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	20,000	-20,400	-80,000	120,400
Annual IC Time Burden (Hours)	7,334	-5,066	667	11,733
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.