Donor

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⚠️ Notice: This information collection may be referencing outdated material.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 Federal CCF Donor Form and Instruction
Federal CCF Federal CCF Att C Fed CCF.pdf Form and Instruction
DOT Federal CCF DOT Federal CCF DOT 2013_Fed CCF.pdf Form and Instruction
Att A Executive Order 12564.pdf Authorizing Leg and Exec Order 12564 IC Document
Att B URMG revised 2017.pdf UrMG IC Document

Information Collection (IC) Details

IC Title:	Donor	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	Federal CCF	Federal CCF	Att C Fed CCF.pdf		Yes	Yes	Fillable Fileable
Form and Instruction	DOT Federal CCF	DOT Federal CCF	DOT 2013_Fed CCF.pdf		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 5,400,000	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	5,400,000	-750,000	6,150,000
Annual IC Time Burden (Hours)	432,000	-80,500	512,500
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

Title	Document	Date Uploaded
Authorizing Leg and Exec Order 12564	Att A Executive Order 12564.pdf	04/27/2017
UrMG	Att B URMG revised 2017.pdf	04/27/2017

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