OMB.report

Federal forms, ICRs, and supporting documents

Information Collection Request

[NIOSH] Fire Fighter Fatality Investigation and Prevention Program Survey

ICR 202310-0920-015 · OMB 0920-1373 · Received in OIRA

Forms and Documents
DocumentTypeStatusAvailability
Form 0920-1373 Company Officers Form and Instruction Modified Repair queued
Form 0920-1373 Fire Chiefs Form and Instruction Modified Repair queued
Form 0920-1373 Firefighters Form and Instruction Modified Repair queued
Att9. FFFIPP Sampling Plan.docx Supplementary Document Uploaded 2023-10-31 Repair queued
Att10. Recruitment Dissemination Plan.pptx Supplementary Document Uploaded 2023-10-31 Repair queued
Att8. FFFIPP Survey Reminder.docx Supplementary Document Uploaded 2023-10-31 Repair queued
Att7.IRB Determination.pdf Supplementary Document Uploaded 2023-10-31 Repair queued
Att6. Data Confidentiality.docx Supplementary Document Uploaded 2023-10-31 Missing upstream
Att5. Survey Invitation.docx Supplementary Document Uploaded 2023-10-31 Repair queued
Att4. FFFIPP Survey Invite-Email .docx Supplementary Document Uploaded 2023-10-31 Missing upstream
Att3. Invite-Phone Script .docx Supplementary Document Uploaded 2023-10-31 Repair queued
Att2a. Survey Screenshot.docx Supplementary Document Uploaded 2023-10-31 Repair queued
Att1. Authorizing legislation.docx Supplementary Document Uploaded 2023-10-31 Missing upstream
NIOSH FFFIPP OMB_Statement B_090823.docx Supporting Statement B Uploaded 2023-10-31 Repair queued
NIOSH FFFIPP OMB_Statement A_090823.docx Supporting Statement A Uploaded 2023-10-31 Missing upstream
IC Document Collections
IC IDCollectionTypeStatusForm
254853 Company Officers Form and Instruction Modified
254852 Fire Chiefs Form and Instruction Modified
254851 Firefighters Form and Instruction Modified
ICR Details
0920-1373 202310-0920-015
Received in OIRA 202207-0920-010
HHS/CDC 0920-1373
[NIOSH] Fire Fighter Fatality Investigation and Prevention Program Survey
Revision of a currently approved collection   No
Regular 10/31/2023
  Requested Previously Approved
36 Months From Approved 10/31/2023
13,500 13,500
4,050 4,050
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
  88 FR 56832 08/21/2023
88 FR 74190 10/30/2023
No
3
IC Title Form No. Form Name
Company Officers 0920-1373 Att1b. FFFIPP Survey-Officer
Fire Chiefs 0920-1373 Att1c. FFFIPP Survey-Chief
Firefighters 0920-1373 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 13,500 0 0 0 0
Annual Time Burden (Hours) 4,050 4,050 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No
$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.
10/31/2023