Mass Layoff Statistics Program

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1220-0090 can be found here:

Documents and Forms

Document Name Document Type
Collection Instrument for Business Function.doc Other-Screen Shot
Job Aid - Script.doc Suggested Wording IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Mass Layoff Statistics Program	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

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
Other-Screen Shot			Collection Instrument for Business Function.doc		Yes	Yes	Fillable Fileable

Line of Business: General Government

Subfunction: Central Records & Statistical Mgt

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 17,052	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Not-for-profit institutions, Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	17,832	0	0	17,832
Annual IC Time Burden (Hours)	69,753	94	-2,928	72,587
Annual IC Cost Burden (Dollars)	0	0	0	0

Documents for IC

Title	Document	Date Uploaded
Suggested Wording	Job Aid - Script.doc	02/12/2007

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