Donor

Mandatory Guidelines for Federal Workplace Drug Testing Programs

Documents and Forms

Document Name Document Type
Form 0930-0158 _2023_Fe Donor Form and Instruction
0930-0158 _2023_Fe 0930-0158 _2023_FedCCF_PROOF 0930-0158 CCF_Tab D_2023_FedCCF_PROOF.pdf Form and Instruction
0930-0158 _2023_Fe 0930-0158 _2023_FedCCF_PROOF 0930-0158 CCF_Tab D_2023_FedCCF_PROOF.pdf Form and Instruction
0930-0158 CCF_TAB A_ Executive Orders _ 12564.pdf 0930-0158 CCF_TAB A_ Executive Orders _ 12564 IC Document
0930-0158 CCF_TAB A_ Executive Orders _ 12564.pdf 0930-0158 CCF_TAB A_ Executive Orders _ 12564 IC Document
0930-0158 CCF_Tab B_UrMG_2017.pdf 0930-0158 CCF_Tab B_UrMG_2017 IC Document
0930-0158 CCF_Tab B_UrMG_2017.pdf 0930-0158 CCF_Tab B_UrMG_2017 IC Document

Information Collection (IC) Details

IC Title:	Donor	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

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	0930-0158 _2023_FedCCF_PROOF	0930-0158 _2023_FedCCF_PROOF	0930-0158 CCF_Tab D_2023_FedCCF_PROOF.pdf		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 6,726,610	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	6,726,610	6,726,610
Annual IC Time Burden (Hours)	538,129	538,129
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
0930-0158 CCF_TAB A_ Executive Orders _ 12564	0930-0158 CCF_TAB A_ Executive Orders _ 12564.pdf	03/21/2023
0930-0158 CCF_Tab B_UrMG_2017	0930-0158 CCF_Tab B_UrMG_2017.pdf	03/21/2023

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