View Information Collection (IC)

View Information Collection (IC)

View Information Collection (IC)

IC Title:	Data collection for evidence-based revisions to the Fire Fighter Fatality Investigation and Prevention Program Line of Duty Death reports	Agency IC Tracking Number:	0920-22GL

IC Status: New

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
Other-Screening questions			APPENDIX A_FFFIPP report revisions_060822.docx		Yes	Yes	Fillable Fileable
Other-Script for verbal informed consent			APPENDIX B_FFFIPP report revisions_06082022.docx		Yes	Yes	Fillable Fileable
Other-Semi-structured interview guide (no investigation)			APPENDIX C_FFFIPP report revisions_06082022.docx		Yes	Yes	Fillable Fileable
Other-Semi-structured interview guide (w/ investigation)			APPENDIX D_FFFIPP report revisions_06082022.docx		Yes	Yes	Fillable Fileable

Federal Enterprise Architecture Business Reference Module

Line of Business: Workforce Management

Subfunction: Worker Safety

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 100	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	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	100	0	100	0	0	0
Annual IC Time Burden (Hours)	107	0	107	0	0	0
Annual IC Cost Burden (Dollars)	0	0	0	0	0	0

Documents for IC

Title	Document	Date Uploaded
GenIC Request Form	Fast_Track_GenIC_Request_FFFIPP report revisions_06132022.docx	06/21/2022

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.