Information Collection

Work Activities Journal

IC 189147 under ICR 200905-0920-001 · OMB 0920-0706.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0706 can be found here:

Documents and Forms

Document Name Document Type
Work Activities Journal Form
Work Activities Journal Att C-2a. Work Activities Journal.xls Form
Att C-2b. Work Activities Journal Instructions.doc Instructions for Work Activity Journal IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Work Activities Journal	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

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
Form	none	Work Activities Journal	Att C-2a. Work Activities Journal.xls		No	No	Paper Only

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 368	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 0 %

	Requested	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	368	368
Annual IC Time Burden (Hours)	736	736
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Instructions for Work Activity Journal	Att C-2b. Work Activities Journal Instructions.doc	04/29/2009

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