OMB.report

Federal forms, ICRs, and supporting documents

Information Collection Request

Fire Fighter Fatality Investigation and Prevention Program Survey

ICR 202207-0920-010 · OMB 0920-1373 · Received in OIRA

Forms and Documents
DocumentTypeStatusAvailability
Form 0920-22DW Company Officers Form and Instruction New Repair queued
Form 0920-22DW Fire Chiefs Form and Instruction New Repair queued
Form 0920-22DW Firefighters Form and Instruction New Repair queued
Att2a. Survey Screenshot.docx Supplementary Document Uploaded 2022-07-26 Repair queued
Att3. Invite-Phone Script .docx Supplementary Document Uploaded 2022-07-26 Repair queued
Att4. FFFIPP Survey Invite-Email .docx Supplementary Document Uploaded 2022-07-26 Repair queued
Att5. Survey Invitation.docx Supplementary Document Uploaded 2022-07-26 Repair queued
Att6. Data Confidentiality.docx Supplementary Document Uploaded 2022-07-26 Repair queued
Att7.IRB Determination.pdf Supplementary Document Uploaded 2022-07-26 Repair queued
Att8. FFFIPP Survey Reminder.docx Supplementary Document Uploaded 2022-07-26 Repair queued
Att9. FFFIPP Sampling Plan.docx Supplementary Document Uploaded 2022-07-26 Repair queued
Att2. 60-day FRN.pdf Supplementary Document Uploaded 2022-07-26 Repair queued
Att10. Recruitment Dissemination Plan.pptx Supplementary Document Uploaded 2022-07-26 Repair queued
Att1. Authorizing legislation.docx Supplementary Document Uploaded 2022-07-26 Missing upstream
NIOSH FFFIPP OMB_Statement B_053122.docx Supporting Statement B Uploaded 2022-07-26 Repair queued
NIOSH FFFIPP OMB_Statement A_060122.docx Supporting Statement A Uploaded 2022-07-26 Repair queued
IC Document Collections
IC IDCollectionTypeStatusForm
254853 Company Officers Form and Instruction New
254852 Fire Chiefs Form and Instruction New
254851 Firefighters Form and Instruction New
ICR Details
202207-0920-010
Received in OIRA
HHS/CDC 0920-22DW
Fire Fighter Fatality Investigation and Prevention Program Survey
New collection (Request for a new OMB Control Number)   No
Regular 07/26/2022
  Requested Previously Approved
12 Months From Approved
13,500 0
4,050 0
0 0
The Centers for Disease Control and Prevention (CDC), National Institute for Occupational Safety and Health (NIOSH) seeks approval from the Office of Management and Budget (OMB) to conduct an evaluation of fire department implementation of the NIOSH Fire Fighter Fatality Investigation and Prevention Program (FFFIPP). This is a new Information Collection Request (ICR), with approval requested for one-year post-approval date.
None
None
Not associated with rulemaking
  87 FR 4894 01/31/2022
87 FR 41318 07/12/2022
No
3
IC Title Form No. Form Name
Company Officers 0920-22DW Att1b. FFFIPP Survey-Officer
Fire Chiefs 0920-22DW Att1c. FFFIPP Survey-Chief
Firefighters 0920-22DW Att1a. FFFIPP Survey-Firefighter
  Total Request 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 13,500 0 0 13,500 0 0
Annual Time Burden (Hours) 4,050 0 0 4,050 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
Miscellaneous Actions
No
The Fire Fighter Fatality Investigation and Prevention Program (FFFIPP) conducts independent investigations of FF LODD and recommends ways to prevent deaths and injuries. An estimated 13,500 respondents are anticipated to participate in the survey; the annual respondent burden is estimated to be 4,050 hours.
$178,937
No
    No
    No
No
No
No
No
Odion Clunis 770 488-0045 [email protected]
  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.
07/26/2022