View Information Collection (IC)
Skip to main content
An official website of the United States government
The .gov means it's official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you're on a federal government site.
The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.
Search:
Agenda
Reg Review
ICR
View Information Collection (IC)
View Information Collection (IC)
IC Title:
Msg Testing for (3) Expedited Reviews--Detonation of an Improv Nuc Devise (Span), AND Impact of a Truck Driver Pub Hth Prac Proj, AND Dissemination of Occup Safety & Hlth Materials thru Mex Consul
Agency IC Tracking Number:
IC Status:
Unchanged
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
Instruction
Attachment D - Moderator's Guide.docx
Yes
Yes
Printable Only
Form
none
Screening Instrument
Attachment C - Screening Instrument.docx
Yes
Yes
Fillable Printable
Instruction
Attachment E - Participant Information Sheet.docx
Yes
Yes
Paper Only
Other-Screen shots
Attachment C- Screen Shots.pdf
Yes
Yes
Printable Only
Other-video
Attachment D - Sleep Debt PSA_30 seconds.mp3
Yes
Yes
Printable Only
Other-video
Attachment F - Whole World Changes PSA_60 seconds.mp3
Yes
Yes
Printable Only
Other-video
Attachment E - Whole World Changes PSA_30 seconds.mp3
Yes
Yes
Printable Only
Form
none
Truck Driver Opinion Survey
Attachment B - Truck Driver Opinion Survey.docx
Yes
Yes
Fillable Printable
Other-Recruitment Script_Spanish
Attachment B-Recruitment Script_Spanish.docx
Yes
Yes
Printable Only
Other-Recruitment Script_English Translation
Attachment C-Recruitment Script_English Translation.docx
Yes
Yes
Printable Only
Form
none
Exit Survey_Spanish
Attachment D-Exit Survey_Spanish.docx
Yes
Yes
Printable Only
Other-Test
FinalScript_English_051812.doc
Yes
Yes
Printable Only
Form
none
Exit Survey_English Translation
Attachment E-Exit Survey_English Translation.docx
Yes
Yes
Printable Only
Other-Test
FinalScript_Spanish_051812.doc
Yes
Yes
Printable Only
Other-Test document
GeneralTest113012v01.pdf
Yes
Yes
Printable Only
Other-Testing document
HotelTest113012v01.pdf
Yes
Yes
Printable Only
Other-Testing document
SoftskillsTest120312v01.pdf
Yes
Yes
Printable Only
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Public Health Monitoring
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
644
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
100 %
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
644
0
0
0
0
644
Annual IC Time Burden (Hours)
199
0
0
0
0
199
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
Attachment A - Protocol Summary
Attachment A - Protocol Summary.docx
12/14/2012
Attachment B - Protocol Detail
Attachment B - Protocol Detail.docx
12/14/2012
HMTS Expedited Review Form 112812
HMTS Expedited Review Form 112812.pdf
12/14/2012
List of Attachments
List of Attachments.docx
12/14/2012
Attachment A - Background Information
Attachment A - Background Information.docx
12/14/2012
NIOSH Hitchcock HMTS Expedited Review Form 110612
NIOSH Hitchcock HMTS Expedited Review Form 110612.pdf
12/14/2012
List of Attachments
List of Attachments.docx
12/14/2012
HMTS Expedited Review Form 120312
HMTS Expedited Review Form 120312.pdf
12/14/2012
List of Attachments
List of Attachments.docx
12/14/2012
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.