Information Collection

Job Accommodation Network

IC 202613 under ICR 201108-1225-001 · OMB 1225-0086.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1225-0086 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
JAN SGA for OMB PRA Clearance 5-25-12.doc www.grants.gov	Instruction
Sample Logic Model for JAN SGA 05_25_12_revised.doc www.grants.gov	Instruction
JAN SGA_OIRA Memo(20120607).doc Justification	IC Document

IC Title:

Job Accommodation Network

Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Required to Obtain or Retain Benefits

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
Instruction			JAN SGA for OMB PRA Clearance 5-25-12.doc	www.grants.gov	Yes	Yes	Fillable Fileable
Instruction			Sample Logic Model for JAN SGA 05_25_12_revised.doc	www.grants.gov	Yes	Yes	Fillable Fileable

Line of Business: Workforce Management

Subfunction: Training and Employment

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 10

Number of Respondents for Small Entity: 10

Affected Public: Private Sector

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

Percentage of Respondents Reporting Electronically: 50 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	10	10
Annual IC Time Burden (Hours)	200	200
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Justification	JAN SGA_OIRA Memo(20120607).doc	06/07/2012

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