Information Collection

NFR Enrollment Questionnaire

IC 269709 under ICR 202606-0920-001 · OMB 0920-1348.

Documents and Forms

Document Name Document Type
Form 0920-26-0116 Enrollment Questionnaire NFR Enrollment Questionnaire Form and Instruction
0920-26-0116 Enrollment Questionnaire 0920-1348 Enrollment Questionnaire.docx Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	NFR Enrollment Questionnaire	Agency IC Tracking Number:	0920-26-0116

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	0920-26-0116	Enrollment Questionnaire	0920-1348 Enrollment Questionnaire.docx	N/A	Yes	Yes	Fillable Fileable

Line of Business: Workforce Management

Subfunction: Worker Safety

Privacy Act System of Records
Title: Epidemiologic Studies and Surveillance of Disease Problems	FR Citation: 57 FR 62812

Number of Respondents: 33,333	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Requested	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	33,333	33,333
Annual IC Time Burden (Hours)	11,111	11,111
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

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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