Contractor Survey-Field Nurse Survey

Contractor Surveys under the Federal Employees Compensation Act

Documents and Forms

Document Name Document Type
Field Nurse Survey-oct 19.pdf Other-survey
revised Field Nurse Letter revised sep24.doc Instruction

Information Collection (IC) Details

IC Title:	Contractor Survey-Field Nurse Survey	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
Instruction			revised Field Nurse Letter revised sep24.doc		No		Paper Only
Other-survey			Field Nurse Survey-oct 19.pdf		No		Fillable Printable

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records
Title: DOL/GOVT-1	FR Citation: 67 FR 16826

Number of Respondents: 162	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	162	162
Annual IC Time Burden (Hours)	40	40
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

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.