Information Collection

Work Organization Predictors of Depression in Women (Participant Questionnaire)

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

Documents and Forms

Documents and forms in this information collection
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

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of 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 %

table that charts list of burden
	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

table that charts IC Documents
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.