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Federal forms, ICRs, and supporting documents

Information Collection

Physician Application for Certification (CDC/NIOSH 2.12)

IC 183370 under ICR 202104-0920-005 · OMB 0920-0020.

Documents and Forms
Document Name
Document Type
Form and Instruction
Form and Instruction
Form and Instruction
Information Collection (IC) Details

View Information Collection (IC)

Physician Application for Certification (CDC/NIOSH 2.12)
 
No Modified
 
Mandatory
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction 2.12 Physician Application for Certification 2.12_Form_Physician Application for Certification 2.12_Removedcitydate.docx Yes No Fillable Printable

Health Illness Prevention

09-20-0149-Morbidity Studies in Coal Mining, Metal and Non-Metal Mining and General Industry and 0920-0153- Mortality Studies in coal Mining, Metal and Non-Metal Mining and General Industry.  51 FR 42476

80 0
   
Private Sector Businesses or other for-profits
 
   50 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 80 0 0 0 0 80
Annual IC Time Burden (Hours) 13 0 0 0 0 13
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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