Information Collection

Childhood Injury and Adult Occupational Injury Suvey

IC 36791 under ICR 200511-0535-001 · OMB 0535-0235.

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Documents and Forms

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Information Collection (IC) Details

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IC Title:	Childhood Injury and Adult Occupational Injury Suvey	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Migrated

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

Line of Business:

Subfunction:

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 14,360	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Farms

Percentage of Respondents Reporting Electronically: 2 %

	Approved	Program Change Due to Agency Discretion	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	13,069	-179,413	41,982	150,500
Annual IC Time Burden (Hours)	6,068	-7,889	1,846	12,111
Annual IC Cost Burden (Dollars)	0	0	0	0

Documents for IC

Title	Document	Date Uploaded

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