[NIOSH] National Firefighter Registry for Cancer

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form 0920-1348 National Firefighter Registry (NFR) Enrollment Questionnaire 18MAR2025	Form and Instruction	Modified	Available
Enrollment Questionnaire	Form and Instruction	Modified	Available
NFR Enrollment Questionnaire	Form and Instruction	Modified	Missing upstream
Form 0920-1348 NFR User Profile 18MAR2025	Form and Instruction	Modified	Available
User Profile	Form	Modified	Available
NFR User Profile	Form	Modified	Repair queued
Informed Consent	Form and Instruction	Unchanged	Available
Informed Consent	Form and Instruction	Unchanged	Missing upstream
Justification for change March 2025.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2025-03-18	Available
Justification for change March 2025.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2025-03-18	Missing upstream
Attachment 8. Non-research determination.pdf	Supplementary Document	Uploaded 2024-07-30	Available
Attachment 8. Non-research determination.pdf	Supplementary Document	Uploaded 2024-07-30	Repair queued
Attachment 7. AOC.docx	Supplementary Document	Uploaded 2024-07-30	Available
Attachment 7. AOC.docx	Supplementary Document	Uploaded 2024-07-30	Repair queued
Attachment 6. Privacy Impact Assessment.pdf	Supplementary Document	Uploaded 2024-07-30	Available
Attachment 6. Privacy Impact Assessment.pdf	Supplementary Document	Uploaded 2024-07-30	Repair queued
Attachment 5. RFI 2019.pdf	Supplementary Document	Uploaded 2024-07-30	Available
Attachment 5. RFI 2019.pdf	Supplementary Document	Uploaded 2024-07-30	Repair queued
Attachment 4c. NIOSH-Palm-Card_4x9-508.pdf	Supplementary Document	Uploaded 2024-07-30	Available
Attachment 4c. NIOSH-Palm-Card_4x9-508.pdf	Supplementary Document	Uploaded 2024-07-30	Repair queued
Attachment 4b. NFR Fact Sheet.pdf	Supplementary Document	Uploaded 2024-07-30	Available
Attachment 4b. NFR Fact Sheet.pdf	Supplementary Document	Uploaded 2024-07-30	Repair queued
Attachment 4a. Invitation to Participate.pdf	Supplementary Document	Uploaded 2024-07-30	Available
Attachment 4a. Invitation to Participate.pdf	Supplementary Document	Uploaded 2024-07-30	Repair queued
Attachment 2. 60 day FRN.pdf	Supplementary Document	Uploaded 2024-07-30	Available
Attachment 2. 60 day FRN.pdf	Supplementary Document	Uploaded 2024-07-30	Repair queued
Attachment 1. Authorizing Legislation.pdf	Supplementary Document	Uploaded 2024-07-30	Available
Attachment 1. Authorizing Legislation.pdf	Supplementary Document	Uploaded 2024-07-30	Missing upstream
Supporting Statement B_7_11_24_final.docx	Supporting Statement B	Uploaded 2024-07-30	Available
Supporting Statement B_7_11_24_final.docx	Supporting Statement B	Uploaded 2024-07-30	Repair queued
Supporting Statement A_9_5_24.docx	Supporting Statement A	Uploaded 2024-09-09	Available
Supporting Statement A_9_5_24.docx	Supporting Statement A	Uploaded 2024-09-09	Repair queued

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
269710	Records Request	Other-email	Unchanged
269709	NFR Enrollment Questionnaire	Form and Instruction	Modified	National Firefighter Registry (NFR) Enrollment Questionnaire 18MAR2025
269709	NFR Enrollment Questionnaire	Form and Instruction	Modified	Enrollment Questionnaire
269709	NFR Enrollment Questionnaire	Form and Instruction	Modified
269708	NFR User Profile	Form and Instruction	Modified	NFR User Profile 18MAR2025
269708	NFR User Profile	Form	Modified	User Profile
269708	NFR User Profile	Form	Modified
244765	Informed Consent	Form and Instruction	Unchanged	Informed Consent
244765	Informed Consent	Form and Instruction	Unchanged

ICR Details

OMB Control No: 0920-1348	ICR Reference No: 202503-0920-021
Status: Historical Active	Previous ICR Reference No: 202407-0920-007
Agency/Subagency: HHS/CDC	Agency Tracking No: 0920-1348-25-0052
Title: [NIOSH] National Firefighter Registry for Cancer
Type of Information Collection: No material or nonsubstantive change to a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 04/03/2025
Retrieve Notice of Action (NOA)	Date Received in OIRA: 03/28/2025
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	04/30/2026	04/30/2026	04/30/2026
Responses	200,032	0	200,032
Time Burden (Hours)	44,987	0	44,987
Cost Burden (Dollars)	0	0	0

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Abstract: The main goal of the National Firefighter Registry (NFR), according to the Firefighter Cancer Registry Act of 2018, is, “to develop and maintain a voluntary registry of firefighters to collect relevant health and occupational information of such firefighters for purposes of determining cancer incidence.” This Non-Substantive Change Request is submitted for the following reason(s): 1) Modification of R/E question to follow the recently released Statistical Policy Directive 15 (SPD-15) Standard in the NFR Enrollment Questionnaire; 2) Removal of three questions in the Enrollment Questionnaire that are being asked exclusively in the User Profile; and 3) Modification of Sex question to conform to EO 14168. There is no change to the burden hours approved for this data collection.

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Authorizing Statute(s): None

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	89 FR 20478	03/22/2024
30-day Notice:	Federal Register Citation:	Citation Date:
	89 FR 65354	08/09/2024
Did the Agency receive public comments on this ICR? Yes

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Number of Information Collection (IC) in this ICR: 4

table that charts list of burden

IC Title	Form No.	Form Name
Informed Consent	n/a	Informed Consent
NFR Enrollment Questionnaire	n/a, 0920-1348	Enrollment Questionnaire ,   National Firefighter Registry (NFR) Enrollment Questionnaire 18MAR2025
NFR User Profile	n/a, 0920-1348	User Profile ,   NFR User Profile 18MAR2025
Records Request

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ICR Summary of Burden

table that charts list of burden

	Total Approved	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	200,032	200,032	0	0	0	0
Annual Time Burden (Hours)	44,987	44,987	0	0	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement:

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Annual Cost to Federal Government: $5,500,000

Does this IC contain surveys, censuses, or employ statistical methods? Yes Part B of Supporting Statement

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     Yes

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? No

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Common Form ICR:  No

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 03/28/2025

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