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

View Information Collection (IC)

Flint Rash Investigation 16AEB
 
Unchanged
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction NA Follow-Up Flint Rash Dermatology Report Form Att B Flint Rash Dermatology Follow-up Report Form.docx NA No   Paper Only

Health Consumer Health and Safety

09-19-0001 Record of Persons Exposed or Potentially Exposed to Toxic or Hazardous Substances  76 FR 4432

150 0
   
Individuals or Households
 
   0 %

  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 150 0 0 0 0 150
Annual IC Time Burden (Hours) 25 0 0 0 0 25
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Letter of Invitation Att A MDHHS Derm Follow up assistance request 0419-2016.pdf 04/19/2016
Supporting Statement B SSB ACE Invstg Flint Rash Drmtlgy Fllw-up.docx 04/19/2016
Research Determination Att C Flint Rash Dermatology Follow-up RDF Signed.pdf 04/19/2016
0923-0051 GenIC Request Request ACE Investsgtn Form_Flint Rash Follow-up.pdf 04/19/2016
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.