Information Collection

Multiple Worksite Report

IC 169090 under ICR 199102-1220-003 · OMB 1220-0134.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1220-0134 can be found here:

Documents and Forms

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Information Collection (IC) Details

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IC Title:	MULTIPLE WORKSITE REPORT	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Migrated

Obligation to Respond: Mandatory

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	BLS 3020				No	No

Line of Business:

Subfunction:

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 110,000	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	440,000	220,000	220,000
Annual IC Time Burden (Hours)	162,800	81,400	81,400
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

Title	Document	Date Uploaded

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