Donor

Mandatory Guidelines for Federal Workplace Drug Testing Programs

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0930-0158 can be found here:

Documents and Forms

Document Name Document Type
Form Federal CCF Donor Form and Instruction
Federal CCF Federal CCF Att D 2013_FedCCF_PROOFtoHHS_130730 Final.pdf Form and Instruction
Att C FR MG effective date final.pdf FR MG effective date final IC Document
Att A Executive Order 12564.pdf Executive Order 12564 IC Document
Att B FR MG 2008.pdf FR MG 2008 IC Document

Information Collection (IC) Details

IC Title:	Donor	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Unchanged

Obligation to Respond: Required to Obtain or Retain Benefits

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	Federal CCF	Federal CCF	Att D 2013_FedCCF_PROOFtoHHS_130730 Final.pdf		Yes	Yes	Fillable Printable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 6,150,000	Number of Respondents for Small Entity: 0

Affected Public: Federal Government

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Previously Approved
Annual Number of Responses for this IC	6,150,000	6,150,000
Annual IC Time Burden (Hours)	512,500	512,500
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
FR MG effective date final	Att C FR MG effective date final.pdf	07/16/2013
Executive Order 12564	Att A Executive Order 12564.pdf	07/16/2013
FR MG 2008	Att B FR MG 2008.pdf	07/16/2013

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