[NIOSH] National Firefighter Registry for Cancer

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form 0920-26-0116 Enrollment Questionnaire	Form and Instruction	Modified	Available
Form 0920-26-0116 NFR User Profile (web-portal registration)	Form and Instruction	Modified	Available
Form 0920-26-0116 Informed Consent	Form and Instruction	Modified	Available
Attachment 3a. Privacy Impact Assessment.rtf	Supplementary Document	Uploaded 2026-06-03	Available
Attachment 3b. Privacy Threshold Analysis.rtf	Supplementary Document	Uploaded 2026-06-03	Available
Attachment 4. AOC.pdf	Supplementary Document	Uploaded 2026-06-03	Available
Attachment 5. Non-research detrmination 2026.pdf	Supplementary Document	Uploaded 2026-06-03	Available
Justification for change March 2025.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2025-03-18	Available
Attachment 8. Non-research determination.pdf	Supplementary Document	Uploaded 2024-07-30	Available
Attachment 7. AOC.docx	Supplementary Document	Uploaded 2024-07-30	Available
Attachment 6. Privacy Impact Assessment.pdf	Supplementary Document	Uploaded 2024-07-30	Available
Attachment 5. RFI 2019.pdf	Supplementary Document	Uploaded 2024-07-30	Available
Attachment 4c. NIOSH-Palm-Card_4x9-508.pdf	Supplementary Document	Uploaded 2024-07-30	Available
Attachment 4b. NFR Fact Sheet.pdf	Supplementary Document	Uploaded 2024-07-30	Available
Attachment 4a. Invitation to Participate.pdf	Supplementary Document	Uploaded 2024-07-30	Available
Attachment 2. 60 day FRN.pdf	Supplementary Document	Uploaded 2024-07-30	Available
Attachment 1. Authorizing Legislation.pdf	Supplementary Document	Uploaded 2024-07-30	Available
Supporting Statement B.docx	Supporting Statement B	Uploaded 2026-06-03	Available
Supporting Statement A-6.3.26.docx	Supporting Statement A	Uploaded 2026-06-03	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
269710	Records Request	Other-email	Modified
269709	NFR Enrollment Questionnaire	Form and Instruction	Modified	Enrollment Questionnaire
269708	User Profile (web-portal registration)	Form and Instruction	Modified	NFR User Profile (web-portal registration)
244765	Informed Consent	Form and Instruction	Modified	Informed Consent

ICR Details

OMB Control No: 0920-1348	ICR Reference No: 202606-0920-001
Status: Received in OIRA	Previous ICR Reference No: 202503-0920-021
Agency/Subagency: HHS/CDC	Agency Tracking No: 0920-26-0116
Title: [NIOSH] National Firefighter Registry for Cancer
Type of Information Collection: Reinstatement with change of a previously approved collection	Common Form ICR:  No
Type of Review Request: Regular	Date Submitted to OIRA: 06/03/2026

table that charts list comparision

	Requested	Previously Approved
Expiration Date	36 Months From Approved
Responses	100,029	0
Time Burden (Hours)	17,157	0
Cost Burden (Dollars)	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.” The purpose of this information collection is for general purpose statistics to be gathered from a registry of U.S. firefighters with the intent to monitor cancer incidence and risk factors among the U.S. fire service. This reinstatement request of information collection #0920-1348 is to continue collecting voluntary data from firefighters through the National Firefighter Registry (NFR) for Cancer in accordance with the Firefighter Cancer Registry Act of 2018

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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:
	91 FR 8879	02/24/2026
30-day Notice:	Federal Register Citation:	Citation Date:
	91 FR 31461	05/27/2026
Did the Agency receive public comments on this ICR? No

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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	0920-26-0116	Informed Consent
NFR Enrollment Questionnaire	0920-26-0116	Enrollment Questionnaire
Records Request
User Profile (web-portal registration)	0920-26-0116	NFR User Profile (web-portal registration)

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ICR Summary of Burden

table that charts list of burden

	Total Request	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	100,029	0	0	100,029	0	0
Annual Time Burden (Hours)	17,157	0	0	17,157	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

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

Burden Reduction Due to:

Short Statement: This is a reinstament with changes- requesting three years of approval for an annual burden of 17,157 hours.

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Annual Cost to Federal Government: $9,500,000

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: 06/03/2026

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