Information Collection

[NIOSH] Assessment of Task-Based Exposures that may Affect Reproductive Health in Nail Salon Employees

IC 267350 under ICR 202506-0920-010 · OMB 0920-1154.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-1154 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 0920-1154 [NIOSH] Assessment of Task-Based Exposures that may Affect Reproductive Health in Nail Salon Employees	Form and Instruction
Form 0920-1154 Nail Salon Exposure Study Questionnaire (24FD) [NIOSH] Assessment of Task-Based Exposures that may Affect Reproductive Health in Nail Salon Employees	Form and Instruction
Form 0920-1154 Nail Salon Exposure Study Questionnaire Feedback Form (24FD) [NIOSH] Assessment of Task-Based Exposures that may Affect Reproductive Health in Nail Salon Employees	Form
0920-1154 Nail Salon Exposure Study Questionnaire (24FD) Questionnaire040224_updated.docx	Form and Instruction
0920-1154 Nail Salon Exposure Study Questionnaire (24FD) Questionnaire040224_updated.docx	Form and Instruction
0920-1154 Nail Salon Exposure Study Questionnaire Feedback Form (2 FeedbackForm040224.docx	Form
0920-1154 Nail Salon Exposure Study Questionnaire Feedback Form (2 FeedbackForm040224.docx	Form
Supporting Statement A.docx SSA (24FD)	IC Document
Supporting Statement A.docx SSA (24FD)	IC Document
Supporting Statement B.docx SSB (24FD)	IC Document
Supporting Statement B.docx SSB (24FD)	IC Document
Attmt I- Authorizing Legislation.docx Authorizing Legislation	IC Document
Attmt I- Authorizing Legislation.docx Authorizing Legislation	IC Document
Attachment 4- IRB Determination.docx Human Subjects Research Determination (24FD)	IC Document
Attachment 4- IRB Determination.docx Human Subjects Research Determination (24FD)	IC Document

IC Title:

[NIOSH] Assessment of Task-Based Exposures that may Affect Reproductive Health in Nail Salon Employees

Agency IC Tracking Number:

0920-1154-24FD

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
Form and Instruction	0920-1154				Yes	Yes	Fillable Fileable
Form	0920-1154				No		Paper Only

Line of Business: Workforce Management

Subfunction: Worker Safety

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 12

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Requested	Previously Approved
Annual Number of Responses for this IC	12	12
Annual IC Time Burden (Hours)	6	6
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
SSA (24FD)		04/30/2024
SSB (24FD)		04/30/2024
Authorizing Legislation		04/30/2024
Human Subjects Research Determination (24FD)		04/30/2024

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

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