Laboratory Application

Mandatory Guidelines for Federal Workplace Drug Testing Programs

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0930-0158 can be found here:

Documents and Forms

Document Name Document Type
Form Urine Lab App Form Laboratory Application Form and Instruction
Urine Lab App Form Urine Lab App Form Att D 2017 Urine Lab App form.pdf Form and Instruction
Urine Lab a_b_c Ch Urine Lab a_b_c Checklist Att E 2017 Urine Lab a_b_c checklist.pdf Form and Instruction
Att F 2017 IITF App Form.pdf IITF App Form IC Document
Att G 2017 IITF a_b_c_checklist.pdf IITF a_b_c_Checklist IC Document

Information Collection (IC) Details

IC Title:	Laboratory Application	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

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	Urine Lab App Form	Urine Lab App Form	Att D 2017 Urine Lab App form.pdf		Yes	Yes	Fillable Fileable
Form and Instruction	Urine Lab a_b_c Checklist	Urine Lab a_b_c Checklist	Att E 2017 Urine Lab a_b_c checklist.pdf		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 1	Number of Respondents for Small Entity: 0

Affected Public: Federal Government

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	1	-2	3
Annual IC Time Burden (Hours)	3	-6	9
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

Title	Document	Date Uploaded
IITF App Form	Att F 2017 IITF App Form.pdf	04/27/2017
IITF a_b_c_Checklist	Att G 2017 IITF a_b_c_checklist.pdf	04/27/2017

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