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Mod 05 EHLR Basic Measuring Success Knowledge Assessment
[ATSDR] Assessment of Environmental Health and Land Reuse Certification Training
OMB: 0923-0060
IC ID: 261513
OMB.report
HHS/TSDR
OMB 0923-0060
ICR 202307-0923-001
IC 261513
( )
Documents and Forms
Document Name
Document Type
Form 0923-0060
Mod 05 EHLR Basic Measuring Success Knowledge Assessment
Form and Instruction
0923-0060 Mod 05 EHLR Basic Measuring Success Knowledge Assessment
Att4e-Mod05EHLRBasic (online)RSTw-Chg.pdf
Form and Instruction
0923-0060 Mod 05 EHLR Basic Measuring Success Knowledge Assessment
Att4e-Mod05EHLRBasic (online)RSTw-Chg.pdf
Form and Instruction
Att4e-Mod05EHLRBasic (online)RSTw-Chg.pdf
Mod 05 EHLR Basic Measuring Success Knowledge Assessment
IC Document
Att4e-Mod05EHLRBasic (online)RSTw-Chg.pdf
Mod 05 EHLR Basic Measuring Success Knowledge Assessment
IC Document
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Mod 05 EHLR Basic Measuring Success Knowledge Assessment
Agency IC Tracking Number:
0923-0060
Is this a Common Form?
No
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
0923-0060
Mod 05 EHLR Basic Measuring Success Knowledge Assessment
Att4e-Mod05EHLRBasic (online)RSTw-Chg.pdf
NA
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Workforce Management
Subfunction:
Training and Employment
Privacy Act System of Records
Title:
09-20-0161 Records of Health Professional in Disease Prevention and Control Training Programs, HHS/CDC/NCPS
FR Citation:
83 FR 6591
Number of Respondents:
100
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
100 %
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
100
0
0
100
0
0
Annual IC Time Burden (Hours)
8
0
0
8
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
Mod 05 EHLR Basic Measuring Success Knowledge Assessment
Att4e-Mod05EHLRBasic (online)RSTw-Chg.pdf
08/09/2023
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.