Information Collection

Worker Classification Survey-Employer Interview

IC 209148 under ICR 201303-1235-002 · OMB 1235-0028.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Worker Classification Survey-OMB Attachment E 09-13-13.docx	Other-Survey
Worker Classification Survey-OMB Attachment B Privacy Statement 09-13-13.docx Worker Classification Survey OMB Attachment B-Privacy Statement	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-Survey			Worker Classification Survey-OMB Attachment E 09-13-13.docx		Yes	No	Printable Only

Line of Business: Workforce Management

Subfunction: Labor Rights Management

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 100

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

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	120	120
Annual IC Time Burden (Hours)	45	45
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Worker Classification Survey OMB Attachment B-Privacy Statement	Worker Classification Survey-OMB Attachment B Privacy Statement 09-13-13.docx	11/01/2013

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