Information Collection

Follow-up Questions - ALS-associated and Clinical Factors

IC 257949 under ICR 202408-0923-001 · OMB 0923-0041.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0923-0041 can be found here:

Documents and Forms

Document Name Document Type
Follow-up Questions - ALS-associated and Clinical Factors Form and Instruction
Follow-up Questions - ALS-associated and Clinical Factors Form and Instruction
ALS-associated and Clinical Factors P_AppE6 - ALS-related Clinical Factors.docx Form and Instruction
ALS-associated and Clinical Factors P_AppE6 - ALS-related Clinical Factors.docx Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Follow-up Questions - ALS-associated and Clinical Factors	Agency IC Tracking Number:	0923-0041

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	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	n/a	ALS-associated and Clinical Factors	P_AppE6 - ALS-related Clinical Factors.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title: Records of Persons Exposed or Potentially Exposed to Hazardous or Toxic Substances	FR Citation: 76 FR 4432

Number of Respondents: 750	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	750	750
Annual IC Time Burden (Hours)	88	88
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.