NIOSH/NYCAMH Tractor Parts Dealers Survey

ROPS Attributes Identified by Distribution Channel Intermediaries

Documents and Forms

Document Name Document Type
Attachment C1- Survey.docx Other-WORD
Appx C_ Screen shots.pdf Other-WORD
Appx C_ Screen shots.pdf Appx C_Screen Shots IC Document

Information Collection (IC) Details

IC Title:	NIOSH/NYCAMH Tractor Parts Dealers Survey	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			Attachment C1- Survey.docx		Yes	Yes	Fillable Printable
Other-WORD			Appx C_ Screen shots.pdf		Yes	Yes	Fillable Printable

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 520	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	520	520
Annual IC Time Burden (Hours)	43	43
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Appx C_Screen Shots	Appx C_ Screen shots.pdf	07/22/2014

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