Information Collection

[NIOSH] Formative Assessment of the Information Needs to Prevent Skin Cancer Among Spanish speaking Outdoor Workers

IC 261060 under ICR 202507-0920-010 · 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⚠️ Notice: This information collection may be referencing outdated material.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 0920-23GU Attmt III- Focus Group Guide - English_Spanish [NIOSH] Formative Assessment of the Information Needs to Prevent Skin Cancer Among Spanish speaking Outdoor Workers	Form and Instruction
0920-23GU Attmt III- Focus Group Guide - English_Spanish Attmt III- Focus Group Guide - English_Spanish.docx	Form and Instruction
Attmt I- Authorizing Legislation.docx Attmt I- Authorizing Legislation	IC Document
Attmt II- DSI IRB_Nonresearch_Flynn_Skin Cancer Outdoor Workers.pdf Attmt II- DSI IRB_Nonresearch_Flynn_Skin Cancer Outdoor Workers	IC Document
Attmt IV- Recruitment_Consent_Form_English_Spanish.docx Attmt IV- Recruitment_Consent_Form_English_Spanish	IC Document
Supporting Statement A_07-10-2023.docx SSA	IC Document
Supporting Statement B.docx Supporting Statement B	IC Document

IC Title:

[NIOSH] Formative Assessment of the Information Needs to Prevent Skin Cancer Among Spanish speaking Outdoor Workers

Agency IC Tracking Number:

0920-23GU

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	0920-23GU				Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 28

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Requested	Previously Approved
Annual Number of Responses for this IC	28	28
Annual IC Time Burden (Hours)	42	42
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Attmt I- Authorizing Legislation		07/12/2023
Attmt II- DSI IRB_Nonresearch_Flynn_Skin Cancer Outdoor Workers		07/12/2023
Attmt IV- Recruitment_Consent_Form_English_Spanish		07/12/2023
SSA		07/12/2023
Supporting Statement B		07/12/2023

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

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