Laboratory Application

Mandatory Guidelines for Federal Workplace Drug Testing Programs

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0930-0158 can be found here:

Documents and Forms

Document Name Document Type
Form Urine Lab App form Laboratory Application Form and Instruction
Urine Lab App form 2018 Urine Lab App form 2018 Urine Lab App form.Final.pdf Form and Instruction
Urine Lab App form 2018 Urine Lab App form 2018 Urine Lab App form.Final.pdf Form and Instruction
Urine Lab a_b_c Ch 2018 Urine Lab a_b_c Checklist 2018 Urine Lab a_b_c checklist.Final.pdf Form and Instruction
Urine Lab a_b_c Ch 2018 Urine Lab a_b_c Checklist 2018 Urine Lab a_b_c checklist.Final.pdf Form and Instruction
2019 IITF App Form.pdf 2019 IITF App Form IC Document
2019 IITF App Form.pdf 2019 IITF App Form IC Document
2018 IITF a_b_c_checklist.Final.pdf 2018 IITF a_b_c Checklist IC Document
2018 IITF a_b_c_checklist.Final.pdf 2018 IITF a_b_c Checklist IC Document

Information Collection (IC) Details

IC Title:	Laboratory Application	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Unchanged

Obligation to Respond: Required to Obtain or Retain Benefits

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	Urine Lab App form	2018 Urine Lab App form	2018 Urine Lab App form.Final.pdf		Yes	Yes	Fillable Fileable
Form and Instruction	Urine Lab a_b_c Checklist	2018 Urine Lab a_b_c Checklist	2018 Urine Lab a_b_c checklist.Final.pdf		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 5	Number of Respondents for Small Entity: 0

Affected Public: Federal Government

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Previously Approved
Annual Number of Responses for this IC	5	5
Annual IC Time Burden (Hours)	15	15
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
2019 IITF App Form	2019 IITF App Form.pdf	06/30/2020
2018 IITF a_b_c Checklist	2018 IITF a_b_c_checklist.Final.pdf	06/30/2020

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