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Federal forms, ICRs, and supporting documents

Information Collection

Health Screening Questionnaire-Forest Service

IC 43556 under ICR 201506-0596-007 · OMB 0596-0164.

Documents and Forms
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Form
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Information Collection (IC) Details

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Health Screening Questionnaire-Forest Service
 
No Modified
 
Required to Obtain or Retain Benefits
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form FS-5100-31 Health Screening Questionnaire FS-5100-31 v8-2009.doc http://www.fs.fed.us/fire/safety/wct/wct_index.html Yes No Fillable Printable
Form FS 5100-30 Work Capacity Test - Informed Consent 0596-0164 FS_5100_30 v07-2015 final_508.docx http://www.fs.fed.us/fire/safety/wct/wct_index.html Yes Yes Fillable Printable

Disaster Management Emergency Response

 

12,630 0
   
Individuals or Households
 
   40 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 25,260 0 0 0 0 25,260
Annual IC Time Burden (Hours) 2,097 0 0 0 0 2,097
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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