ToxFAQs Before and After Testing

Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0923-0047 can be found here:

Documents and Forms

Document Name Document Type
ToxFAQs Before and After Testing Form and Instruction
Tox FAQs Before and After Testing Survey - Online Attachment-E_ToxFAQs Before and After Testing Survey (online).docx Form and Instruction
0923-0047_NCEH-ATSDR-Generic-Clearance-for-Qualitative-Feedback-ToxFAQs.pdf GenIC Request IC Document
Attachment-A_ToxFAQs Before and After Testing Protocol.docx ToxFAQs Before and After Testing Protocol IC Document
Attachment-B_ToxFAQs Before and After Fact Sheets.docx ToxFAQs Before and After Testing Fact Sheets IC Document
Attachment-C_ToxFAQs Before and After Testing Email Invitation.docx ToxFAQs Before and After Testing Email Invitation IC Document
Attachment-D_ToxFAQs Before and After Testing Survey (text).docx ToxFAQs Before and After Testing Survey - Text IC Document

Information Collection (IC) Details

IC Title:	ToxFAQs Before and After Testing	Agency IC Tracking Number:	16AH

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
Form and Instruction	NA	Tox FAQs Before and After Testing Survey - Online	Attachment-E_ToxFAQs Before and After Testing Survey (online).docx	NA	Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 250	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	250	250
Annual IC Time Burden (Hours)	83	83
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
GenIC Request	0923-0047_NCEH-ATSDR-Generic-Clearance-for-Qualitative-Feedback-ToxFAQs.pdf	12/18/2015
ToxFAQs Before and After Testing Protocol	Attachment-A_ToxFAQs Before and After Testing Protocol.docx	12/18/2015
ToxFAQs Before and After Testing Fact Sheets	Attachment-B_ToxFAQs Before and After Fact Sheets.docx	12/18/2015
ToxFAQs Before and After Testing Email Invitation	Attachment-C_ToxFAQs Before and After Testing Email Invitation.docx	12/18/2015
ToxFAQs Before and After Testing Survey - Text	Attachment-D_ToxFAQs Before and After Testing Survey (text).docx	12/18/2015

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