Information Collection

Invoice-Pathologist

IC 197447 under ICR 202111-0920-021 · 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⚠️ Notice: This information collection may be referencing outdated material.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

Documents and forms in this information collection
Document Name	Document Type
Form CWHSP 2.19, Dec 20 Invoice-Pathologist	Form and Instruction
CWHSP 2.19, Dec 20 Authorization for Payment of Autopsy Attachment 22 Auth for Pay of Autopsy Form No. CDC NIOSH (M) 2.19.pdf	Form and Instruction
CWHSP 2.19, Dec 20 Authorization for Payment of Autopsy Attachment 22 Auth for Pay of Autopsy Form No. CDC NIOSH (M) 2.19.pdf	Form and Instruction

IC Title:

Invoice-Pathologist

Agency IC Tracking Number:

0920-0020

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
Form and Instruction	CWHSP 2.19, Dec 2020	Authorization for Payment of Autopsy	Attachment 22 Auth for Pay of Autopsy Form No. CDC NIOSH (M) 2.19.pdf		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Illness Prevention

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 4

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	4	3	1
Annual IC Time Burden (Hours)	1	1	0
Annual IC Cost Burden (Dollars)	4	4	0

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.