View Information Collection (IC)

View Information Collection (IC)

View Information Collection (IC)

IC Title:	Customer Survey to Solicit Feedback on NIOSH Workplace Guidance Documents	Agency IC Tracking Number:	0920-0953-23BL

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
Form and Instruction	n/a	Questionnaire	Appx A- Questionnaire.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: 82,632	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 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	82,632	0	82,632	0	0	0
Annual IC Time Burden (Hours)	6,887	0	6,887	0	0	0
Annual IC Cost Burden (Dollars)	0	0	0	0	0	0

Documents for IC

Title	Document	Date Uploaded
GenIC Request Template	Fast Track OMB Request template_final.docx	12/02/2022
Email Distribution	Appx B- email distribution.docx	12/02/2022
Dissemination List	Appx C- Dissemination List.xlsx	12/02/2022

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