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Federal forms, ICRs, and supporting documents

Information Collection

Employer documentation of refusal to provide blood, breath urine specimens for chemical test

IC 185219 under ICR 202306-1625-002 · OMB 1625-0001.

Documents and Forms
Document Name
Document Type
Instruction
Information Collection (IC) Details

View Information Collection (IC)

Employer documentation of refusal to provide blood, breath urine specimens for chemical test
 
No Unchanged
 
Mandatory
 
46 CFR 4.06

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Instruction 1625-0001_Inst_r9_2021-inv.docx Yes Yes Printable Only

Transportation Water Transportation

DHS/USCG-013 Marine Information for Safety and Law Enforcement (MISLE)  74 FR 30305

1 0
   
Private Sector Businesses or other for-profits
 
   80 %

  Requested 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 1 0 0 0 0 1
Annual IC Time Burden (Hours) 1 0 0 0 0 1
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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.