Information Collection

Medical Surveillance - Provision of Information to Physicians by Employers

IC 182440 under ICR 201401-2070-002 · OMB 2070-0072.

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Documents and Forms

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Information Collection (IC) Details

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IC Title:	Medical Surveillance - Provision of Information to Physicians by Employers	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 40 CFR 763, Subpart G (To search for a specific CFR, visit the Code of Federal Regulations.)

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability

Line of Business: Environmental Management

Subfunction: Pollution Prevention and Control

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 2,888	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Previously Approved
Annual Number of Responses for this IC	2,888	2,888
Annual IC Time Burden (Hours)	241	241
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

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