Information Collection Request

[NIOSH] National Firefighter Registry for Cancer

ICR 202503-0920-021 · OMB 0920-1348 · Active

Forms and Documents

Document Name	Status
NFR Enrollment Questionnaire Form and Instruction	Modified
NFR Enrollment Questionnaire Form and Instruction	Modified
NFR User Profile Form	Modified
NFR User Profile Form	Modified
Informed Consent Form and Instruction	Unchanged
Informed Consent Form and Instruction	Unchanged
Justification for change March 2025.docx Justification for No Material/Nonsubstantive Change	2025-03-18
Justification for change March 2025.docx Justification for No Material/Nonsubstantive Change	2025-03-18
Attachment 8. Non-research determination.pdf Supplementary Document	2024-07-30
Attachment 8. Non-research determination.pdf Supplementary Document	2024-07-30
Attachment 7. AOC.docx Supplementary Document	2024-07-30
Attachment 7. AOC.docx Supplementary Document	2024-07-30
Attachment 6. Privacy Impact Assessment.pdf Supplementary Document	2024-07-30
Attachment 6. Privacy Impact Assessment.pdf Supplementary Document	2024-07-30
Attachment 5. RFI 2019.pdf Supplementary Document	2024-07-30
Attachment 5. RFI 2019.pdf Supplementary Document	2024-07-30
Attachment 4c. NIOSH-Palm-Card_4x9-508.pdf Supplementary Document	2024-07-30
Attachment 4c. NIOSH-Palm-Card_4x9-508.pdf Supplementary Document	2024-07-30
Attachment 4b. NFR Fact Sheet.pdf Supplementary Document	2024-07-30
Attachment 4b. NFR Fact Sheet.pdf Supplementary Document	2024-07-30
Attachment 4a. Invitation to Participate.pdf Supplementary Document	2024-07-30
Attachment 4a. Invitation to Participate.pdf Supplementary Document	2024-07-30
Attachment 2. 60 day FRN.pdf Supplementary Document	2024-07-30
Attachment 2. 60 day FRN.pdf Supplementary Document	2024-07-30
Attachment 1. Authorizing Legislation.pdf Supplementary Document	2024-07-30
Attachment 1. Authorizing Legislation.pdf Supplementary Document	2024-07-30
Supporting Statement B_7_11_24_final.docx Supporting Statement B	2024-07-30
Supporting Statement B_7_11_24_final.docx Supporting Statement B	2024-07-30
Supporting Statement A_9_5_24.docx Supporting Statement A	2024-09-09
Supporting Statement A_9_5_24.docx Supporting Statement A	2024-09-09

IC Document Collections

IC ID	Document Title	Status
269710	Records Request Other-email	Unchanged
269709	NFR Enrollment Questionnaire Form and Instruction	Modified
269709	NFR Enrollment Questionnaire Form and Instruction	Modified
269708	NFR User Profile Form	Modified
269708	NFR User Profile Form	Modified
244765	Informed Consent Form and Instruction	Unchanged
244765	Informed Consent Form and Instruction	Unchanged

ICR Details

Status	Active
Agency/Subagency	HHS/CDC
OMB Control No	0920-1348
Type of Information Collection	No material or nonsubstantive change to a currently approved collection
Previous ICR Reference No	202407-0920-007
Agency Tracking No	0920-1348-25-0052
Date Submitted to OIRA	2025-03-28
Requested Expiration Date	1969-12-31