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ICR
View Information Collection (IC)
View Information Collection (IC)
IC Title:
[NIOSH] Usability Testing of Toolbox Talks for Landscaping and Tree Care Workers
Agency IC Tracking Number:
0920-0953-23BU
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
Usability Testing Guide
Attachment A- Usability Testing Guide.docx
No
Fillable Fileable
Form and Instruction
n/a
Informed Consent
Attachment B- Informed Consent.docx
No
Fillable Fileable
Form and Instruction
n/a
Usability Testing Guide (Spanish)
Attachment F- Usability Testing Guide-Spanish.docx
No
Fillable Fileable
Form and Instruction
n/a
Informed Consent (Spanish)
Attachment G- Informed Consent-Spanish.docx
No
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:
60
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
10 %
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
60
0
60
0
0
0
Annual IC Time Burden (Hours)
65
0
65
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 Clearance Submission Template_Usability Testing of Toolbox Talks_01-10-23_Clean.docx
01/12/2023
Research Determination
Attachment C- Non-Research Determination.pdf
01/06/2023
Organizational Recruitment Letter and Script
Attachment D- Organizational Recruitment Letter and Script.docx
01/06/2023
Recruitment Flyer
Attachment E- Recruitment Flyer.docx
01/06/2023
Organizational Recruitment Letter and Script (Spanish)
Attachment H- Organizational Recruitment Letter and Script-Spanish.docx
01/12/2023
Recruitment Flyer (Spanish)
Attachment I- Recruitment Flyer-Spanish.docx
01/12/2023
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.