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Federal forms, ICRs, and supporting documents

Information Collection Request

TRADE NAME REQUEST FORM FOR NATIONAL OCCUPATIONAL HAZARD SURVEY

ICR 197412-0920-002 · OMB 0920-0022 · Historical Active

Forms and Documents
DocumentTypeStatusAvailability
No forms / supporting documents in this ICR. Check IC Document Collections.
IC Document Collections
IC IDCollectionTypeStatusForm
110575 TRADE NAME REQUEST FORM FOR NATIONAL OCCUPATIONAL HAZARD SURVEY Form Migrated
ICR Details
0920-0022 197412-0920-002
Historical Active
HHS/CDC
TRADE NAME REQUEST FORM FOR NATIONAL OCCUPATIONAL HAZARD SURVEY
Extension without change of a currently approved collection   No
Regular
Approved without change 12/24/1974
Retrieve Notice of Action (NOA) 12/18/1974
  Inventory as of this Action Requested Previously Approved
12/31/1975 12/31/1975
126,000 0 0
31,500 0 0
0 0 0

None
None
No
1
IC Title Form No. Form Name
TRADE NAME REQUEST FORM FOR NATIONAL OCCUPATIONAL HAZARD SURVEY NIOSH15
  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 126,000 0 0 0 126,000 0
Annual Time Burden (Hours) 31,500 0 0 0 31,500 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No
$0
No
No
Uncollected
Uncollected
Uncollected
Uncollected
  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.
12/18/1974