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Federal forms, ICRs, and supporting documents

Information Collection

Appx A _Adult Initial Survey & Consent

IC 251052 under ICR 202212-0923-001 · OMB 0923-0064.

Documents and Forms
Document Name
Document Type
Form and Instruction
Form and Instruction
Form and Instruction
Information Collection (IC) Details

View Information Collection (IC)

Appx A _Adult Initial Survey & Consent 0923-0064-23BK
 
No Modified
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction 0923-0064 Consent to Take Part in a Research Study and Initial Survey (Adult ≥ 18 years of age) P_ApndxA_InAdltSrvyCnsnt.docx No   Fillable Fileable

Health Public Health Monitoring

Records of Persons Exposed or Potentially Exposed to Hazardous or Toxic Substances (retrievable by name or SSN)  76 FR 4431

1,400 0
   
Individuals or Households
 
   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 1,400 0 0 0 0 1,400
Annual IC Time Burden (Hours) 700 0 0 0 0 700
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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