Information Collection

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

IC 267350 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⚠️ Notice: This information collection may be referencing outdated material.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 0920-1154 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 Feedback Form (2 FeedbackForm040224.docx	Form
Supporting Statement A.docx SSA (24FD)	IC Document
Supporting Statement B.docx SSB (24FD)	IC Document
Attmt I- Authorizing Legislation.docx Authorizing Legislation	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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