Information Collection

Color vision test procedures

IC 243749 under ICR 202109-0920-011 · OMB 0920-1332.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Attachment 12 Color vision test SOP.docx	Instruction
Attachment 12 Color vision test SOP.docx	Instruction
Attachment 13 Color vision results form.docx Color vision test results	IC Document
Attachment 13 Color vision results form.docx Color vision test results	IC Document

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Instruction			Attachment 12 Color vision test SOP.docx		No		Paper Only

Line of Business: Workforce Management

Subfunction: Worker Safety

Privacy Act System of Records

Title: Occupational Health Epidemiological Studies and EEOICPA Program Records and WTC Health Program Records

FR Citation: 76 FR 34706

Number of Respondents: 338

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	338	0	338
Annual IC Time Burden (Hours)	28	0	28
Annual IC Cost Burden (Dollars)	642	-7	649

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Color vision test results	Attachment 13 Color vision results form.docx	09/23/2020

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.