Information Collection

ALS Biorepository Specimen Processing

IC 222083 under ICR 202605-0923-001 · OMB 0923-0041.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Biorepository Specimen Processing ALS Biorepository Specimen Processing	Form
Biorepository Specimen Processing APPENDIX_S.A-1_Biorepository_Specimen_Processing_Form[1].docx	Form

IC Title:

Agency IC Tracking Number:

0923-26-0185

Is this a Common Form? No

IC Status: Modified

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	none				Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title: Records of Persons Exposed or Potentially Exposed to Toxic or Hazardous Substances, 09-19-0001

FR Citation: 76 FR 4432

Number of Respondents: 325

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	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	325	0	325
Annual IC Time Burden (Hours)	162	-1	163
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
No associated records found

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

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