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Federal forms, ICRs, and supporting documents

Information Collection

Reporting of Serious Injuries and Death

IC 219464 under ICR 202304-0970-001 · OMB 0970-0473.

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

View Information Collection (IC)

Reporting of Serious Injuries and Death
 
No Modified
 
Required to Obtain or Retain Benefits
 
45 CFR 98

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Instruction Instrument 1 - CCDF Consumer Education Website and Reports of Serious Injuries and Death Instructions Final 2023.docx Yes Yes Fillable Fileable

Community and Social Services Social Services

 

10,000 0
   
State, Local, and Tribal Governments
 
   100 %

  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 10,000 0 0 0 0 10,000
Annual IC Time Burden (Hours) 10,000 0 0 0 0 10,000
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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