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ALS Biorepository Specimen Processing
[ATSDR] National Amyotrophic Lateral Sclerosis (ALS) Registry
OMB: 0923-0041
IC ID: 222083
OMB.report
HHS/TSDR
OMB 0923-0041
ICR 202301-0923-001
IC 222083
( )
Documents and Forms
Document Name
Document Type
ALS Biorepository Specimen Processing
Form
Biorepository Specimen Processing
P_AppS.A-1 Biorepository Specimen Processing Form.docx
Form
Biorepository Specimen Processing
P_AppS.A-1 Biorepository Specimen Processing Form.docx
Form
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
ALS Biorepository Specimen Processing
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Modified
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
none
Biorepository Specimen Processing
P_AppS.A-1 Biorepository Specimen Processing Form.docx
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Public Health Monitoring
Privacy Act System of Records
Title:
Records of Persons Exposed or Potentially Exposed to Toxic or Hazardous Substances, 09-19-0001
FR Citation:
76 FR 4432
Number of Respondents:
325
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
325
0
0
0
0
325
Annual IC Time Burden (Hours)
163
0
0
0
0
163
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.
