Information Collection

Workload and Time Management Survey

IC 194608 under ICR 201009-0920-003 · OMB 0920-0874.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Att C-1. Workload Mgmt Survey REV 11.24.2010[1].pdf	Other-Word
Att C-3. F-U Email_09BV.doc Att C-3	IC Document
Att C-2. Cvr Email WLM Survey_09BV.doc Att C-2	IC Document
Att C-1. WLM Survey_09BV[1].doc Att C-1.WLM Survey_09BV	IC Document

IC Title:

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
Other-Word			Att C-1. Workload Mgmt Survey REV 11.24.2010[1].pdf		Yes	Yes	Fillable Printable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 46

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	46	46
Annual IC Time Burden (Hours)	184	184
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Att C-3	Att C-3. F-U Email_09BV.doc	08/26/2010
Att C-2	Att C-2. Cvr Email WLM Survey_09BV.doc	08/26/2010
Att C-1.WLM Survey_09BV	Att C-1. WLM Survey_09BV[1].doc	11/29/2010

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