Information Collection

Work Organization Predictors of Depression in Women (Participant Questionnaire)

IC 7097 under ICR 200807-0920-004 · OMB 0920-0630.

Documents and Forms

Document Name Document Type
Appendix C_ Participant Questionnaire_0630.doc Other-WORD
Appendix C-1 Survey Interview Transcript.doc Appendix C-1 Survey Interview Transcript IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Work Organization Predictors of Depression in Women (Participant Questionnaire)	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-WORD			Appendix C_ Participant Questionnaire_0630.doc		Yes	Yes	Fillable Printable

Line of Business: Health

Subfunction: Illness Prevention

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 314	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	314	314
Annual IC Time Burden (Hours)	236	236
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Appendix C-1 Survey Interview Transcript	Appendix C-1 Survey Interview Transcript.doc	07/01/2008

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