Information Collection

Distribution of Traceable Opioid Material§ Kits across U.S. Laboratories

IC 235913 under ICR 201810-0923-002 · OMB 0923-0047.

⚠️ Notice: This information collection may be referencing outdated material.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

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 0923-0047 Distribution of Traceable Opioid Material§ Kits across U.S. Laboratories	Form and Instruction
0923-0047 Traceable Opioid Material* Kit Questions Att2_Traceable Opioid Material Kit Questions.pdf	Form and Instruction
Att 1 Traceable Opioid Material Kits Fact Sheet.pdf Traceable Opioid Material Kit FactSheet	IC Document
Att3_PHE PRA Waiver Memo 20190329.pdf PHE PRA Waiver Memo	IC Document
Att4 - RDF - CDC NCEH DLS Traceable Opioid Material Kits crrctd.pdf Research Determination	IC Document
ATSDR 0923-0047 GnrcClrncQualFdbkTmpltapprvlFrm_TOM Kits Distribution_signed OS.pdf ATSDR 0923-0047 GenIC Rwequest	IC Document

IC Title:

Distribution of Traceable Opioid Material§ Kits across U.S. Laboratories

Agency IC Tracking Number:

0923-0047-19ATN

IC Status: New

Obligation to Respond: Voluntary

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 and Instruction	0923-0047	Traceable Opioid Material* Kit Questions	Att2_Traceable Opioid Material Kit Questions.pdf	NA	Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Illness Prevention

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 2,000

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	2,000	2,000
Annual IC Time Burden (Hours)	200	200
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Traceable Opioid Material Kit FactSheet	Att 1 Traceable Opioid Material Kits Fact Sheet.pdf	05/02/2019
PHE PRA Waiver Memo	Att3_PHE PRA Waiver Memo 20190329.pdf	05/02/2019
Research Determination	Att4 - RDF - CDC NCEH DLS Traceable Opioid Material Kits crrctd.pdf	05/02/2019
ATSDR 0923-0047 GenIC Rwequest	ATSDR 0923-0047 GnrcClrncQualFdbkTmpltapprvlFrm_TOM Kits Distribution_signed OS.pdf	05/02/2019

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