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ICR
View Information Collection (IC)
View Information Collection (IC)
IC Title:
[NIOSH] Calibration Study for a Face Measuring Mobile Application
Agency IC Tracking Number:
0920-26-0270
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
Consent Form
Att 1 - Consent Form_final.docx
No
Paper Only
Form and Instruction
N/A
Demographics Questionnaire
Att 2 - Demographics-Questionnaire_Updated.docx
No
Paper Only
Form and Instruction
N/A
Photo Release Form
Att 3 - Photo-Release-Form_final-OMB PB-MB_final.docx
No
Paper Only
Form
N/A
Caliper Measurements Form
Att 4 - Caliper-Measurements-Form.docx
No
Paper Only
Other-Info Sheet
Att 5 - Placeholder - Digital capture of facial images.docx
No
Paper Only
Federal Enterprise Architecture Business Reference Module
Line of Business:
Workforce Management
Subfunction:
Worker Safety
Privacy Act System of Records
Title:
SORN 09-20-0159 Records of Subjects in Certification, Testing, Studies of Personal Protective Devices, and Accident Investigations
FR Citation:
83 FR 6591
Number of Respondents:
35
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
175
0
175
0
0
0
Annual IC Time Burden (Hours)
63
0
63
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
PIA
Att 6 - PIA-form-Calibration-data-collection-updated-12-Aug-2026 1- SIGNED.pdf
09/16/2026
Recruitment Flyer
Att 7 - Recruitment-Flyer.docx
09/16/2026
GenIC Request Template
NPPTL genIC request-Calibration-Data-Set-PRA_Final_final-OMB PB-MB2_final.docx
09/16/2026
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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