Information Collection

HRCT Scan informed consent

IC 249550 under ICR 202109-0920-011 · OMB 0920-1332.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 0920-21ID HRCT Scan informed consent	Form
0920-21ID HRCT consent form Attachment_4_StyreneCohort_HRCT consent form.docx	Form
0920-21ID HRCT consent form Attachment_4_StyreneCohort_HRCT consent form.docx	Form

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

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
Form	0920-21ID	HRCT consent form	Attachment_4_StyreneCohort_HRCT consent form.docx		No		Printable Only

Line of Business: Workforce Management

Subfunction: Training and Employment

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 18

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
Annual Number of Responses for this IC	18	18
Annual IC Time Burden (Hours)	5	5
Annual IC Cost Burden (Dollars)	106	106

Documents for IC

table that charts IC Documents
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.