Information Collection

E-Verify Non-User Survey and Employee-Employer Survey in Arizona

IC 188974 under ICR 200909-1615-005 · OMB 1615-0108.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Non-User Survey 5-19-09 Latest.doc [email protected]	Other-Survey
Worker5-19-09 Latest.doc	Other-Survey
Employer 5-19-09 Latest.doc	Other-Survey

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	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Survey	Non-User Survey 5-19-09 Latest.doc	[email protected]	Yes	Yes	Fillable Fileable
Other-Survey	Worker5-19-09 Latest.doc		No		Printable Only
Other-Survey	Employer 5-19-09 Latest.doc		No		Printable Only

Line of Business: Homeland Security

Subfunction: Key Asset and Critical Infrastructure Protection

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 2,800

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 80 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	2,800	2,800
Annual IC Time Burden (Hours)	1,399	1,399
Annual IC Cost Burden (Dollars)	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.