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Federal forms, ICRs, and supporting documents

Information Collection

Employer Phone Interview Guide

IC 202672 under ICR 201303-0920-012 · OMB 0920-0965.

Documents and Forms
Document Name
Document Type
Other-null
IC Document
IC Document
Information Collection (IC) Details

View Information Collection (IC)

Employer Phone Interview Guide
 
No Modified
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-null Attachment_D-2_NHWP_Employer_Phone_Interview_Guide.docx Yes Yes Fillable Fileable

Health Public Health Monitoring

 

69 21
   
Private Sector Businesses or other for-profits, Not-for-profit institutions
 
   0 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 69 0 69 0 0 0
Annual IC Time Burden (Hours) 23 0 23 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Attachment_D-3_Employer_Interviewer_Instructions Attachment_D-3_Employer_Interviewer_Instructions.docx 03/26/2013
Attachment_D-1_NHWP Eligibility Requirements Attachment_D-1_NHWP Eligibility Requirements.docx 03/26/2013
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.