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

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⚠️ Notice: This information collection may be referencing outdated material.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
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

Information Collection (IC) Details

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:

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 %

	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

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.