Material Testing of Health Hazard Evaluation Program Investigation Reports

Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery (NIOSH)

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0940 can be found here:

Documents and Forms

Document Name Document Type
Task B Appendix B.docx Other-WORD
Task B Appendix A OMB.docx Other-WORD
Task B Appendix C.docx Other-WORD
omb package task b usability testing.docx Supporting Document IC Document

Information Collection (IC) Details

IC Title:	Material Testing of Health Hazard Evaluation Program Investigation Reports	Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-WORD	Task B Appendix B.docx	Yes	Yes	Fillable Printable
Other-WORD	Task B Appendix A OMB.docx	Yes	Yes	Fillable Printable
Other-WORD	Task B Appendix C.docx	Yes	Yes	Fillable Printable

Line of Business: Workforce Management

Subfunction: Worker Safety

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 81	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to New Statute	Program Change Due to Agency Discretion	Change Due to Adjustment in Agency Estimate	Change Due to Potential Violation of the PRA	Previously Approved
Annual Number of Responses for this IC	81	0	0	0	0	0
Annual IC Time Burden (Hours)	90	0	0	0	0	0
Annual IC Cost Burden (Dollars)	0	0	0	0	0	0

Documents for IC

Title	Document	Date Uploaded
Supporting Document	omb package task b usability testing.docx	06/04/2013

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