Flavoring 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 H3_Flav_Announcement.ENG.docx Appx H3_Flav_Announcement IC Document
Appx H4_Flav_Announcement.SPAN.docx Appx H4_Flav_Announcement IC Document
Appx I3_Flav_InfoFactSheet.ENG.docx Appx I3_Flav_InfoFactSheet IC Document
Appx I4_Flav_Info Fact Sheet.SPAN.docx Appx I4_Flav_Info Fact Sheet IC Document

Information Collection (IC) Details

IC Title:	Flavoring 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: 56	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	56	56
Annual IC Time Burden (Hours)	9	9
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Appx H3_Flav_Announcement	Appx H3_Flav_Announcement.ENG.docx	06/21/2013
Appx H4_Flav_Announcement	Appx H4_Flav_Announcement.SPAN.docx	06/21/2013
Appx I3_Flav_InfoFactSheet	Appx I3_Flav_InfoFactSheet.ENG.docx	06/21/2013
Appx I4_Flav_Info Fact Sheet	Appx I4_Flav_Info Fact Sheet.SPAN.docx	06/21/2013

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