Information Collection

ATSDR "Don't Mess with Mercury" Webinar Survey

IC 217925 under ICR 201305-0923-003 · OMB 0923-0047.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0923-0047 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
ATSDR "Don't Mess with Mercury" Webinar Survey	Form
Don't Mess with Mercury Webinar Survey Attachment C - DMWM Webinar Survey (on-line).docx	Form
Attachment A Email Invitation for DMWM Webinar Survey.docx Email Invitation	IC Document
0923-0047 GenIC Request Form DMWM Webinar Survey.pdf Request for Approval	IC Document

IC Title:

ATSDR "Don't Mess with Mercury" Webinar Survey

Agency IC Tracking Number:

15BEE

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	none	Don't Mess with Mercury Webinar Survey	Attachment C - DMWM Webinar Survey (on-line).docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 20

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	20	20
Annual IC Time Burden (Hours)	2	2
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Email Invitation	Attachment A Email Invitation for DMWM Webinar Survey.docx	08/19/2015
Request for Approval	0923-0047 GenIC Request Form DMWM Webinar Survey.pdf	08/19/2015

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