Annual Report

Pulmonary Function Testing Course Approval Program

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0138 can be found here:

Documents and Forms

Document Name Document Type
Annual Report Form
Annual report Attachment D Annual Report.docx Form
Annual report Attachment D Annual Report.docx Form

Information Collection (IC) Details

IC Title:	Annual Report	Agency IC Tracking Number:

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	none	Annual report	Attachment D Annual Report.docx		Yes	Yes	Fillable Fileable

Line of Business: Workforce Management

Subfunction: Worker Safety

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 34	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	34	2	32
Annual IC Time Burden (Hours)	16	0	16
Annual IC Cost Burden (Dollars)	365	13	352

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.