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Federal forms, ICRs, and supporting documents

Information Collection

Att 10 OSHA/NPPTL Medical Evaluation: Annually for all Test Participants_Rev 1 (10.25.2023)

IC 263408 under ICR 202410-0920-021 · OMB 0920-0109.

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Att 10 OSHA/NPPTL Medical Evaluation: Annually for all Test Participants_Rev 1 (10.25.2023) 0920-0109
 
No Unchanged
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form 0920-0109 OSHA/NPPTL Medical Evaluation: Annually for all Test ParticipantsRev 1 (10.25.2023) Atch_10_Health and wellness screeining (annually, all test participants).pdf Yes Yes Fillable Fileable
Form 0920-0109 Test Subject Information Sheet Atch_10_InformationSheet.pdf Yes Yes Fillable Fileable

Workforce Management Worker Safety

 

40 0
   
Individuals or Households
 
   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 40 0 0 0 0 40
Annual IC Time Burden (Hours) 10 0 0 0 0 10
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Consent Form Atch_8a_ConsentForm.pdf 11/14/2023
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.