Information Collection Request

Exigent Health and Safety Deficiency Correction Certification

ICR 201312-2577-002 · OMB 2577-0241 · Historical Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
2577-0241 30 Day FR.pdf Supplementary Document Uploaded 2014-02-27 Available
Initial Privacy Assessment (IPA).doc Supplementary Document Uploaded 2014-01-10 Available
83-i and Supporting Statement.doc Supporting Statement A Uploaded 2014-01-10 Available

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
27931 Required Screens for the Physical Assessment Subsystem (PASS) Exigent Health & Safety (EH&S) Reporting Application Other-Template Modified

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
04/30/2017 36 Months From Approved 04/30/2014
1,134 0 1,263
346 0 334
0 0 0





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table that charts list of burden
IC Title Form No. Form Name
Required Screens for the Physical Assessment Subsystem (PASS) Exigent Health & Safety (EH&S) Reporting Application

table that charts list of burden
  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 1,134 1,263 0 -129 0 0
Annual Time Burden (Hours) 346 334 0 12 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
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