MLS State Government

Mass Layoff Statistics Program

Documents and Forms

Document Name Document Type
Form WINMLS MLS State Government Form
WINMLS Collection Instrument Collection Instrument-Winmls.rtf Form
Confiden-Burden Statement.doc Confidentiality - Burden Statement IC Document

Information Collection (IC) Details

IC Title:	MLS State Government	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

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
Form	WINMLS	Collection Instrument	Collection Instrument-Winmls.rtf		Yes	Yes	Fillable Fileable

Line of Business: General Government

Subfunction: Central Records & Statistical Mgt

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 53	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	848	0	848
Annual IC Time Burden (Hours)	71,880	1,000	70,880
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

Title	Document	Date Uploaded
Confidentiality - Burden Statement	Confiden-Burden Statement.doc	10/11/2011

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