Popcorn workers - Informed Consent

Spectrum of Flavoring Chemical-Related Lung Disease

Documents and Forms

Document Name Document Type
Appx G1_Consent.ENG.docx Other-WORD
Appx G2_Consent.SPAN.docx Other-WORD
Appx H1_Pop_Announcement.ENG.docx Appx H1_Pop_Announcement IC Document
Appx H2_Pop_Announcement.SPAN.docx Appx H2_Pop_Announcement IC Document
Appx I1_Pop_InfoFactSheet.ENG.docx Appx I1_Pop_InfoFactSheet IC Document
Appx I2_Pop_InfoFactSheet. SPAN.docx Appx I2_Pop_InfoFactSheet IC Document

Information Collection (IC) Details

IC Title:	Popcorn workers - Informed Consent	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

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-WORD			Appx G1_Consent.ENG.docx		No	No	Fillable Printable
Other-WORD			Appx G2_Consent.SPAN.docx		No	No	Fillable Printable

Line of Business: Workforce Management

Subfunction: Worker Safety

Privacy Act System of Records
Title: 09-20-0147 Occupatinal Health Epidemiological Studies	FR Citation: 51 FR 42449

Number of Respondents: 81	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	81	81
Annual IC Time Burden (Hours)	14	14
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Appx H1_Pop_Announcement	Appx H1_Pop_Announcement.ENG.docx	06/21/2013
Appx H2_Pop_Announcement	Appx H2_Pop_Announcement.SPAN.docx	06/21/2013
Appx I1_Pop_InfoFactSheet	Appx I1_Pop_InfoFactSheet.ENG.docx	06/21/2013
Appx I2_Pop_InfoFactSheet	Appx I2_Pop_InfoFactSheet. SPAN.docx	06/21/2013

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