Information Collection

U.S. Firefighters Registry

IC 244765 under ICR 202011-0920-010 · OMB 0920-1348.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-1348 can be found here:

Documents and Forms

Document Name Document Type
Form 0920-20MT U.S. Firefighters Registry Form and Instruction
0920-20MT NFR User Profile Attachment 3b. User Profile.docx Form and Instruction
0920-20MT NFR Enrollment Questionnaire Attachment 3c. Questionnaire.docx Form and Instruction
0920-20MT Informed Consent Attachment 3a. Informed Consent.docx Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	U.S. Firefighters Registry	Agency IC Tracking Number:	0920-20MT

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	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	0920-20MT	NFR User Profile	Attachment 3b. User Profile.docx	Yes	Yes	Fillable Fileable
Form and Instruction	0920-20MT	NFR Enrollment Questionnaire	Attachment 3c. Questionnaire.docx	Yes	No	Fillable Fileable
Form and Instruction	0920-20MT	Informed Consent	Attachment 3a. Informed Consent.docx	Yes	No	Fillable Fileable

Line of Business: Workforce Management

Subfunction: Worker Safety

Privacy Act System of Records
Title: Epidemiologic Studies and Surveillance of Disease Problems	FR Citation: 57 FR 62812

Number of Respondents: 66,666	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Requested	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	66,666	66,666
Annual IC Time Burden (Hours)	44,443	44,443
Annual IC Cost Burden (Dollars)	0	0

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.