Information Collection

Personal air sampler

IC 240028 under ICR 202002-0920-009 · OMB 0920-1316.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-1316 can be found here:

Documents and Forms

Document Name Document Type
Att10 Be Outfitted with Personal Air Sampler 20200212.docx Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Personal air sampler	Agency IC Tracking Number:

Is this a Common Form? No		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
Instruction			Att10 Be Outfitted with Personal Air Sampler 20200212.docx		No		Paper Only

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records
Title: Epidemiologic studies and surveillance of disease problems.	FR Citation: 57 FR 62812

Number of Respondents: 67	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	335	335
Annual IC Time Burden (Hours)	251	251
Annual IC Cost Burden (Dollars)	6,137	6,137

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.