Request for Course Change (Example)

[NIOSH] Pulmonary Function Testing Course Approval Program

Documents and Forms

Document Name Document Type
Form 0920-0138 Request for Course Change (Example) Form
0920-0138 Attachment G NIOSH-Example of e-mail request for course Attachment G NIOSH-Example of e-mail request for course change_2024.docx Form
0920-0138 Attachment G NIOSH-Example of e-mail request for course Attachment G NIOSH-Example of e-mail request for course change_2024.docx Form

Information Collection (IC) Details

IC Title:	Request for Course Change (Example)	Agency IC Tracking Number:	0920-0138

Is this a Common Form? Yes		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	0920-0138	Attachment G NIOSH-Example of e-mail request for course change_2024	Attachment G NIOSH-Example of e-mail request for course change_2024.docx		Yes	Yes	Fillable Fileable

Line of Business: Workforce Management

Subfunction: Worker Safety

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 24	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Not-for-profit institutions, Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	24	0	24
Annual IC Time Burden (Hours)	12	0	12
Annual IC Cost Burden (Dollars)	0	-276	276

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.