Information Collection

Occupational Questionnaires

IC 216968 under ICR 202405-0920-002 · OMB 0920-0010.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0010 can be found here:

2025-05-01 - No material or nonsubstantive change to a currently approved collection

Documents and Forms

Document Name Document Type
Occupational Questionnaires Form and Instruction
Occupational Questionnaires Form and Instruction
Agriculture_Screenshots_English AttF1.1a_OOQ_Agriculture.pdf Form and Instruction
Agriculture_Screenshots_English AttF1.1a_OOQ_Agriculture.pdf Form and Instruction
Agriculture_Screenshots_Spanish AttF1.1b_OOQ_Agriculture.pdf Form and Instruction
Agriculture_Screenshots_Spanish AttF1.1b_OOQ_Agriculture.pdf Form and Instruction
Cosmetology_Screenshots_English AttF1.2a_OOQ_Cosmetology.pdf Form and Instruction
Cosmetology_Screenshots_English AttF1.2a_OOQ_Cosmetology.pdf Form and Instruction
Cosmetology_Screenshots_Spanish AttF1.2b_OOQ_Cosmetology.pdf Form and Instruction
Cosmetology_Screenshots_Spanish AttF1.2b_OOQ_Cosmetology.pdf Form and Instruction
Electronic Equipment Operators_Screenshots_English AttF1.3a_OOQ_Electronic_Equipment_Operator.pdf Form and Instruction
Electronic Equipment Operators_Screenshots_English AttF1.3a_OOQ_Electronic_Equipment_Operator.pdf Form and Instruction
Electronic Equipment Operators_Screenshots_Spanish AttF1.3b_OOQ_Electronic_Equipment_Operator.pdf Form and Instruction
Electronic Equipment Operators_Screenshots_Spanish AttF1.3b_OOQ_Electronic_Equipment_Operator.pdf Form and Instruction
Healthcare_Screenshots_English AttF1.4a_OOQ_Healthcare.pdf Form and Instruction
Healthcare_Screenshots_English AttF1.4a_OOQ_Healthcare.pdf Form and Instruction
Healthcare_Screenshots_Spansih AttF1.4b_OOQ_Healthcare.pdf Form and Instruction
Healthcare_Screenshots_Spansih AttF1.4b_OOQ_Healthcare.pdf Form and Instruction
Janitorial_Screenshots_English AttF1.5a_OOQ_Janitorial.pdf Form and Instruction
Janitorial_Screenshots_English AttF1.5a_OOQ_Janitorial.pdf Form and Instruction
Janitorial_Screenshots_Spanish AttF1.5b_OOQ_Janitorial.pdf Form and Instruction
Janitorial_Screenshots_Spanish AttF1.5b_OOQ_Janitorial.pdf Form and Instruction
Office Worker_Screenshots_English AttF1.6a_OOQ_Office_Worker.pdf Form and Instruction
Office Worker_Screenshots_English AttF1.6a_OOQ_Office_Worker.pdf Form and Instruction
Office Worker_Screenshots_Spanish AttF1.6b_OOQ_Office_Worker.pdf Form and Instruction
Office Worker_Screenshots_Spanish AttF1.6b_OOQ_Office_Worker.pdf Form and Instruction
Restaurant Worker_Screenshots_English AttF1.7a_OOQ_Restaurant.pdf Form and Instruction
Restaurant Worker_Screenshots_English AttF1.7a_OOQ_Restaurant.pdf Form and Instruction
Restaurant Worker_Screenshots_Spanish AttF1.7b_OOQ_Restaurant.pdf Form and Instruction
Restaurant Worker_Screenshots_Spanish AttF1.7b_OOQ_Restaurant.pdf Form and Instruction
Teaching_Screenshots_English AttF1.8a_OOQ_Teaching.pdf Form and Instruction
Teaching_Screenshots_English AttF1.8a_OOQ_Teaching.pdf Form and Instruction
Teaching_Screenshots_Spanish AttF1.8b_OOQ_Teaching.pdf Form and Instruction
Teaching_Screenshots_Spanish AttF1.8b_OOQ_Teaching.pdf Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Occupational Questionnaires	Agency IC Tracking Number:	0920-0010

Is this a Common Form? No		IC Status: Unchanged

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	n/a	Agriculture_Screenshots_English	AttF1.1a_OOQ_Agriculture.pdf	Yes	Yes	Fillable Fileable
Form and Instruction	n/a	Agriculture_Screenshots_Spanish	AttF1.1b_OOQ_Agriculture.pdf	Yes	Yes	Fillable Fileable
Form and Instruction	n/a	Cosmetology_Screenshots_English	AttF1.2a_OOQ_Cosmetology.pdf	Yes	Yes	Fillable Fileable
Form and Instruction	n/a	Cosmetology_Screenshots_Spanish	AttF1.2b_OOQ_Cosmetology.pdf	Yes	Yes	Fillable Fileable
Form and Instruction	n/a	Electronic Equipment Operators_Screenshots_English	AttF1.3a_OOQ_Electronic_Equipment_Operator.pdf	Yes	Yes	Fillable Fileable
Form and Instruction	n/a	Electronic Equipment Operators_Screenshots_Spanish	AttF1.3b_OOQ_Electronic_Equipment_Operator.pdf	Yes	Yes	Fillable Fileable
Form and Instruction	n/a	Healthcare_Screenshots_English	AttF1.4a_OOQ_Healthcare.pdf	Yes	Yes	Fillable Fileable
Form and Instruction	n/a	Healthcare_Screenshots_Spansih	AttF1.4b_OOQ_Healthcare.pdf	Yes	Yes	Fillable Fileable
Form and Instruction	n/a	Janitorial_Screenshots_English	AttF1.5a_OOQ_Janitorial.pdf	Yes	Yes	Fillable Fileable
Form and Instruction	n/a	Janitorial_Screenshots_Spanish	AttF1.5b_OOQ_Janitorial.pdf	Yes	Yes	Fillable Fileable
Form and Instruction	n/a	Office Worker_Screenshots_English	AttF1.6a_OOQ_Office_Worker.pdf	Yes	Yes	Fillable Fileable
Form and Instruction	n/a	Office Worker_Screenshots_Spanish	AttF1.6b_OOQ_Office_Worker.pdf	Yes	Yes	Fillable Fileable
Form and Instruction	n/a	Restaurant Worker_Screenshots_English	AttF1.7a_OOQ_Restaurant.pdf	Yes	Yes	Fillable Fileable
Form and Instruction	n/a	Restaurant Worker_Screenshots_Spanish	AttF1.7b_OOQ_Restaurant.pdf	Yes	Yes	Fillable Fileable
Form and Instruction	n/a	Teaching_Screenshots_English	AttF1.8a_OOQ_Teaching.pdf	Yes	Yes	Fillable Fileable
Form and Instruction	n/a	Teaching_Screenshots_Spanish	AttF1.8b_OOQ_Teaching.pdf	Yes	Yes	Fillable Fileable

Federal Enterprise Architecture Business Reference Module

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title: Epidemiologic Studies and Surveillance of Disease Problems	FR Citation: 57 FR 62812

Number of Respondents: 830	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Previously Approved
Annual Number of Responses for this IC	830	830
Annual IC Time Burden (Hours)	277	277
Annual IC Cost Burden (Dollars)	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.