Information Collection

Popcorn workers - Informed Consent

IC 207497 under ICR 201306-0920-011 · OMB 0920-0979.

Documents and Forms

Documents and forms in this information collection
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

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

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
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 %

table that charts list of burden
	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

table that charts IC Documents
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.