Information Collection

Radiation Exposure Screening and Education Program Measures

IC 217672 under ICR 201507-0906-002 · OMB 0906-0012.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0906-0012 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1 Radiation Exposure Screening and Education Program Measures	Form
1 RESEP Performance Meaures_2015.docx RESEP Performance Meaures_2015.docx	Form

IC Title:

Radiation Exposure Screening and Education Program Measures

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Required to Obtain or Retain Benefits

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
Form	1	RESEP Performance Meaures_2015.docx	RESEP Performance Meaures_2015.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 42

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits, Not-for-profit institutions

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	42	42
Annual IC Time Burden (Hours)	1,008	1,008
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
No associated records found

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