View Information Collection Request (ICR) Package

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View ICR - OIRA Conclusion

OMB Control No: 0920-1244	ICR Reference No: 202109-0920-012
Status: Historical Active	Previous ICR Reference No: 201806-0920-005
Agency/Subagency: HHS/CDC	Agency Tracking No: 0920-1244
Title: Assessment of Occupational Injury among Fire Fighters Using a Follow-back Survey
Type of Information Collection: Extension without change of a currently approved collection	Common Form ICR: No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 02/15/2022
	Date Received in OIRA: 10/13/2021
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	02/28/2023	12 Months From Approved	02/28/2022
Responses	35	0	240
Time Burden (Hours)	18	0	120
Cost Burden (Dollars)	454	0	2,915

ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to Agency Discretion
Annual Number of Responses	35	240	-205
Annual Time Burden (Hours)	18	120	-102
Annual Cost Burden (Dollars)	454	2,915	-2,461

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: Yes

Burden Reduction Due to: Miscellaneous Actions

Short Statement: The decrease is due to the request to extend the collection one more year to collect info from a small number of respondents.

Annual Cost to Federal Government: $66,804

Does this IC contain surveys, censuses, or employ statistical methods? Yes Part B of Supporting Statement

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination. No

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination. No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? No

Agency Contact: Kevin Joyce 404 639-1944 kdj7@cdc.gov

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