Medical Monitoring Project

ICR 201311-0920-014

OMB: 0920-0740

Federal Form Document

Forms and Documents
Document
Name
Status
Form
Modified
Form
Modified
Supplementary Document
2013-11-21
Justification for No Material/Nonsubstantive Change
2013-11-21
Supplementary Document
2012-03-26
Supplementary Document
2013-01-30
Supplementary Document
2009-03-12
ICR Details
0920-0740 201311-0920-014
Historical Active 201302-0920-005
HHS/CDC 20996
Medical Monitoring Project
No material or nonsubstantive change to a currently approved collection   No
Regular
Approved without change 11/25/2013
Retrieve Notice of Action (NOA) 11/21/2013
  Inventory as of this Action Requested Previously Approved
05/31/2015 05/31/2015 05/31/2015
20,126 0 20,126
8,537 0 8,537
0 0 0

This request is to make minor changes to the questionnaire with no change in burden or respondents.

PL: Pub.L. 111 - 241 301 Name of Law: Title III - General Powers and Duties of Public Health Service
  
None

Not associated with rulemaking

No

  Total Approved 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 20,126 20,126 0 0 0 0
Annual Time Burden (Hours) 8,537 8,537 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No

$14,700,128
Yes Part B of Supporting Statement
Yes
No
No
No
Uncollected
Shari Steinberg 404 639-4942 sxw2@cdc.gov

  No

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:
 
 
 
 
 
 
 
    (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;
 
 
 
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.
11/21/2013


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