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Consent of Photographic Image Release
Interventions to Reduce Shoulder MSDs in Overhead Assembly
OMB: 0920-0964
IC ID: 205864
OMB.report
HHS/CDC
OMB 0920-0964
ICR 201511-0920-009
IC 205864
( )
Documents and Forms
Document Name
Document Type
Consent of Photographic Image Release
Form
Consent to Photograph
Att H Consent to Photographic Image.docx
Form
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Consent of Photographic Image Release
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Modified
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
none
Consent to Photograph
Att H Consent to Photographic Image.docx
No
Paper Only
Federal Enterprise Architecture Business Reference Module
Line of Business:
Workforce Management
Subfunction:
Worker Safety
Privacy Act System of Records
Title:
09-20-0118 Study at Work Sites Where Agents Suspected of Being Occupational Hazards Exist
FR Citation:
51 FR 42469
Number of Respondents:
63
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
0 %
Approved
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
63
0
63
0
0
0
Annual IC Time Burden (Hours)
2
0
2
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
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.