View Information Collection (IC)
View Information Collection (IC)

View Information Collection (IC)

General Responder Eligibility Application
 
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 and Instruction n/a Yes Yes Fillable Fileable
Form and Instruction 0920-0891 N/A Yes Yes Fillable Fileable
Form and Instruction 0920-0891 N/A Yes Yes Fillable Fileable

Health Health Care Services

09-20-0147 Occupational Health Epidemiological Studies and EEOICPA Program Records and WTC Health Program Records, HHS/CDC/NIOSH  76 FR 34706

6,215 0
   
Individuals or Households
 
   50 %

  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 6,215 0 0 0 6,215 0
Annual IC Time Burden (Hours) 3,108 0 0 0 3,108 0
Annual IC Cost Burden (Dollars) 56,557 0 0 0 56,557 0

Title Document Date Uploaded
WTCHP General Responder Application_NonFDNY_Span_10FEB2025 02/10/2025
WTCHP General Responder Application_NonFDNY_Polish_10FEB2025 02/10/2025
WTCHP General Responder Application_NonFDNY_Span_10FEB2025 02/19/2025
WTCHP General Responder Application_NonFDNY_Polish_19FEB2025 02/19/2025
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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