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EEOICPA Dose Reconstruction Introductory Letters & Telephone Interview
Energy Employees Occupational Illness Compensation Program Act Dose Reconstruction Interviews and Forms (EEOICPA)
OMB: 0920-0530
IC ID: 6981
OMB.report
HHS/CDC
OMB 0920-0530
ICR 202110-0920-006
IC 6981
( )
Documents and Forms
Document Name
Document Type
Form 0920-0530
EEOICPA Dose Reconstruction Introductory Letters & Telephone Interview
Form and Instruction
0920-0530 Telephone Interviews and Intro Letters
Attachment C CATI form_ICRO edits.doc
Form and Instruction
0920-0530 Telephone Interviews and Intro Letters
Attachment C CATI form_ICRO edits.doc
Form and Instruction
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
EEOICPA Dose Reconstruction Introductory Letters & Telephone Interview
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Unchanged
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 and Instruction
0920-0530
Telephone Interviews and Intro Letters
Attachment C CATI form_ICRO edits.doc
NA
No
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Consumer Health and Safety
Privacy Act System of Records
Title:
09-20-0147 Occupational Health Epidemiological Studies and EEOICPA Program Records
FR Citation:
76 FR 34706
Number of Respondents:
3,600
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
0 %
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
3,600
0
0
0
0
3,600
Annual IC Time Burden (Hours)
3,600
0
0
0
0
3,600
Annual IC Cost Burden (Dollars)
0
0
0
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.