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⚠️ Notice: This information collection may be referencing outdated material.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

Documents and forms in this information collection
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

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:

table that charts list of 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 %

table that charts list of burden
	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

table that charts IC Documents
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.