Information Collection

NIOSH/NYCAMH Tractor Parts Dealers Survey

IC 212419 under ICR 201407-0920-010 · OMB 0920-1037.

Documents and Forms

Documents and forms in this information collection
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

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					Yes	Yes	Fillable Printable
Other-WORD					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 %

table that charts list of burden
	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

table that charts IC Documents
Title	Document	Date Uploaded
Appx C_Screen Shots		07/22/2014

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

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