Information Collection

Family and Medical Leave Act Survey- Employer Survey

IC 198682 under ICR 201105-1235-001 · OMB 1235-0026.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1235-0026 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
FMLA OMB Attachment C Employer Survey_Final to OMB_2r[1]-nd.DOC	Other-Telephone Survey

IC Title:

Family and Medical Leave Act Survey- Employer Survey

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Voluntary

CFR Citation: 29 CFR 825

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-Telephone Survey			FMLA OMB Attachment C Employer Survey_Final to OMB_2r[1]-nd.DOC		No		Paper Only

Line of Business: Workforce Management

Subfunction: Labor Rights Management

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 2,572

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits, Farms, 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	2,572	2,572
Annual IC Time Burden (Hours)	2,164	2,164
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.