Information Collection

Records Request

IC 269710 under ICR 202407-0920-007 · OMB 0920-1348.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-1348 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Attachment 9_records request_email.docx	Other-email
Attachment 9_records request_email.docx	Other-email

IC Title:

Records Request

Agency IC Tracking Number:

0920-1348

Is this a Common Form? No

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-email			Attachment 9_records request_email.docx		Yes	Yes	Fillable Fileable

Line of Business: Workforce Management

Subfunction: Worker Safety

Privacy Act System of Records

Title: Epidemiologic Studies and Surveillance of Disease Problems

FR Citation: 57 FR 62812

Number of Respondents: 34

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	34	34
Annual IC Time Burden (Hours)	544	544
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
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.