Information Collection

Multiple Worksite Report (Mandatory)

IC 178400 under ICR 200902-1220-005 · 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⚠️ Notice: This information collection may be referencing outdated material.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

Documents and forms in this information collection
Document Name	Document Type
Form BLS 3020 Multiple Worksite Report Multiple Worksite Report (Mandatory)	Form and Instruction
BLS 3020 Multiple Worksite Report Attachment C (mandatory).pdf	Form and Instruction

IC Title:

Multiple Worksite Report (Mandatory)

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Mandatory

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
Form and Instruction	BLS 3020				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: 72,679

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

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

Percentage of Respondents Reporting Electronically: 7 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	290,716	15,924	274,792
Annual IC Time Burden (Hours)	107,565	5,892	101,673
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
No associated records found

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

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