OMB
.report
Search
EHLR Immersion Community Engagement Module1_Knowledge Assessment
[ATSDR] Assessment of Environmental Health and Land Reuse Certification Training
OMB: 0923-0060
IC ID: 261514
OMB.report
HHS/TSDR
OMB 0923-0060
ICR 202307-0923-001
IC 261514
( )
Documents and Forms
Document Name
Document Type
Form 0923-0060
EHLR Immersion Community Engagement Module1_Knowledge Assessment
Form and Instruction
0923-0060 EHLR Immersion Community Engagement Module Knowledge Ass
Att5a-Mod01-EHLRImm (online) RSTw-Chg.pdf
Form and Instruction
0923-0060 EHLR Immersion Community Engagement Module Knowledge Ass
Att5a-Mod01-EHLRImm (online) RSTw-Chg.pdf
Form and Instruction
Att5a-Mod01-EHLRImm (Word) RSTw-Chg.docx
EHLR Immersion Community Engagement Module Knowledge Assessment
IC Document
Att5a-Mod01-EHLRImm (Word) RSTw-Chg.docx
EHLR Immersion Community Engagement Module Knowledge Assessment
IC Document
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
EHLR Immersion Community Engagement Module1_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
EHLR Immersion Community Engagement Module Knowledge Assessment
Att5a-Mod01-EHLRImm (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:
85 FR 6591
Number of Respondents:
125
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
125
0
25
100
0
0
Annual IC Time Burden (Hours)
31
0
23
8
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
EHLR Immersion Community Engagement Module Knowledge Assessment
Att5a-Mod01-EHLRImm (Word) RSTw-Chg.docx
08/09/2023
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.