Information Collection

Spirometry Facility Employee - Respiratory Assessment 2.13

IC 212086 under ICR 202105-0920-011 · OMB 0920-0020.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0020 can be found here:

Documents and Forms

Document Name Document Type
Form 2.13 Spirometry Facility Employee - Respiratory Assessment 2.13 Form
2.13 Respiratory assessment Attachment 16- Form 2.13.docx Form
2.13 Respiratory assessment Attachment 16- Form 2.13.docx Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Spirometry Facility Employee - Respiratory Assessment 2.13	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

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	2.13	Respiratory assessment	Attachment 16- Form 2.13.docx		Yes	Yes	Fillable Printable

Line of Business: Workforce Management

Subfunction: Worker Safety

Privacy Act System of Records
Title: Mortality Studies in Coal Mining, Metal and Non-Metal Mining and General Industry â 09-20-0153	FR Citation: 51 FR 42476

Number of Respondents: 8,500	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 95 %

	Requested	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	8,500	-6,060	14,560
Annual IC Time Burden (Hours)	709	-505	1,214
Annual IC Cost Burden (Dollars)	0	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.