Information Collection

Providing other specimens

IC 240026 under ICR 202503-0920-004 · OMB 0920-1316.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Att9 Urine Lung function Nasal swabs 20200212.docx	Instruction
Att9 Urine Lung function Nasal swabs 20200212.docx	Instruction
0920-1316 Change Request Att6 How to Collect Urine 06212023.docx Additional Sample Collection - Revised 10JUL2023	IC Document
0920-1316 Change Request Att6 How to Collect Urine 06212023.docx Additional Sample Collection - Revised 10JUL2023	IC Document

IC Title:

Agency IC Tracking Number:

0920-1316

Is this a Common Form? No

IC Status: Unchanged

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
Instruction					No		Paper Only

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records

Title: Epidemiologic studies and surveillance of disease problems.

FR Citation: 57 FR 62812

Number of Respondents: 67

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	Previously Approved
Annual Number of Responses for this IC	670	670
Annual IC Time Burden (Hours)	670	670
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Additional Sample Collection - Revised 10JUL2023		07/11/2023

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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