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Firefighters
[NIOSH] Fire Fighter Fatality Investigation and Prevention Program Survey
OMB: 0920-1373
IC ID: 254851
OMB.report
HHS/CDC
OMB 0920-1373
ICR 202310-0920-015
IC 254851
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-1373 can be found here:
2024-03-06 - No material or nonsubstantive change to a currently approved collection
Documents and Forms
Document Name
Document Type
Form 0920-1373
Firefighters
Form and Instruction
0920-1373 Att1a. FFFIPP Survey-Firefighter
Att1a. FFFIPP Survey-Firefighter .docx
Form and Instruction
0920-1373 Att1a. FFFIPP Survey-Firefighter
Att1a. FFFIPP Survey-Firefighter .docx
Form and Instruction
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Firefighters
Agency IC Tracking Number:
0920-22DW
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 and Instruction
0920-1373
Att1a. FFFIPP Survey-Firefighter
Att1a. FFFIPP Survey-Firefighter .docx
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Workforce Management
Subfunction:
Worker Safety
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
4,500
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
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
4,500
0
0
0
0
4,500
Annual IC Time Burden (Hours)
1,350
0
0
0
0
1,350
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.