Information Collection

Disability Employment Initiative Evaluation Site Visits - Partners & Employers

IC 199066 under ICR 201104-1230-001 · OMB 1230-0006.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
DEI Eval Site Visit Question Matrix.xls	Other-Interview Guide
Interveiw_Protocol_1-25-13_Final.doc Protocol	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-Interview Guide			DEI Eval Site Visit Question Matrix.xls		No		Paper Only

Line of Business: Workforce Management

Subfunction: Labor Rights Management

Privacy Act System of Records

Title: System of Records Notice, DOL/ETA-15

FR Citation: 67 FR 16898

Number of Respondents: 174

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits, Not-for-profit institutions

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	174	174
Annual IC Time Burden (Hours)	131	131
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Protocol	Interveiw_Protocol_1-25-13_Final.doc	01/30/2013

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