OMB
.report
Search
B Reader for Physician
National Coal Workers' Health Surveillance Program (CWHSP)
OMB: 0920-0020
IC ID: 274684
OMB.report
HHS/CDC
OMB 0920-0020
ICR 202501-0920-010
IC 274684
( )
Documents and Forms
Document Name
Document Type
Form 0920-24IK
B Reader for Physician
Form
0920-24IK Physicians reporting outcomes of B Reader Examinations
Attachment 13_Sample Letters to Physicians reporting outcomes of B Reader Examinations.pdf
Form
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
B Reader for Physician
Agency IC Tracking Number:
0920-0020-24IK
Is this a Common Form?
No
IC Status:
New
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
0920-24IK
Physicians reporting outcomes of B Reader Examinations
Attachment 13_Sample Letters to Physicians reporting outcomes of B Reader Examinations.pdf
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Illness Prevention
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
1
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
0 %
Requested
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
1
0
1
0
0
0
Annual IC Time Burden (Hours)
18
0
18
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
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.
