A-ESTABLISHMENT INFORMATION, B-WAGE DATA, C-QUARTERLY REPORT D-BENEFIT DOCUMENT, E-BENEFIT CHANGE DOCUMENT, 3076 REFINEMENT SURVEY

ICR 197707-1220-003

OMB: 1220-0038

Federal Form Document

Forms and Documents
Document
Name
Status
No forms / supporting documents in this ICR. Check IC Document Collections.
ICR Details
1220-0038 197707-1220-003
Historical Active 197702-1220-004
DOL/BLS
A-ESTABLISHMENT INFORMATION, B-WAGE DATA, C-QUARTERLY REPORT D-BENEFIT DOCUMENT, E-BENEFIT CHANGE DOCUMENT, 3076 REFINEMENT SURVEY
No material or nonsubstantive change to a currently approved collection   No
Emergency 07/29/1977
Approved with change 07/29/1977
Retrieve Notice of Action (NOA) 07/29/1977
  Inventory as of this Action Requested Previously Approved
06/30/1978 06/30/1978 06/30/1978
11,362 0 11,362
17,272 0 17,272
0 0 0



None
None


No

1
IC Title Form No. Form Name
A-ESTABLISHMENT INFORMATION, B-WAGE DATA, C-QUARTERLY REPORT D-BENEFIT DOCUMENT, E-BENEFIT CHANGE DOCUMENT, 3076 REFINEMENT SURVEY BLS 3038A,B,, 3076, 3077

  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 11,362 11,362 0 0 0 0
Annual Time Burden (Hours) 17,272 17,272 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No

$0
No
No
Uncollected
Uncollected
Uncollected
Uncollected

  No

On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
 
 
 
 
 
 
 
    (i) Why the information is being collected;
    (ii) Use of information;
    (iii) Burden estimate;
    (iv) Nature of response (voluntary, required for a benefit, or mandatory);
    (v) Nature and extent of confidentiality; and
    (vi) Need to display currently valid OMB control number;
 
 
 
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
07/29/1977


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