Information Collection

ATUS 2017 Leave Questions

IC 220553 under ICR 201408-1220-002 · OMB 1220-0141.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1220-0141 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form Section 1 ATUS 2017 Leave Questions	Form
Section 1 In house Interview Questions Section 1 - In house Interview Questions.docx	Form
Group 1 Online Group 1 questions ATUS Online Group 1 Embedded Probes.pdf	Form and Instruction
Group 1 Online Group 1 Probe at end Questions ATUS Online Group 1 Probes at end.pdf	Form and Instruction
Group 2 Online Group 2 Embedded Probes ATUS Online Group 2 Embedded Probes.pdf	Form and Instruction
Group 2 Group 2 Probes at End ATUS Online Group 2 Probes at end.pdf	Form and Instruction
Note to Reviewer - ATUS Leave Module.docx Note To Reviewer - ATUS 2017 Leave Questions	IC Document

IC Title:

ATUS 2017 Leave Questions

Agency IC Tracking Number:

21610

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	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	Section 1	In house Interview Questions	Section 1 - In house Interview Questions.docx	Yes	No	Printable Only
Form and Instruction	Group 1	Online Group 1 questions	ATUS Online Group 1 Embedded Probes.pdf	Yes	Yes	Fillable Fileable
Form and Instruction	Group 1	Online Group 1 Probe at end Questions	ATUS Online Group 1 Probes at end.pdf	Yes	Yes	Fillable Fileable
Form and Instruction	Group 2	Online Group 2 Embedded Probes	ATUS Online Group 2 Embedded Probes.pdf	Yes	Yes	Fillable Fileable
Form and Instruction	Group 2	Group 2 Probes at End	ATUS Online Group 2 Probes at end.pdf	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: 70

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

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	70	70
Annual IC Time Burden (Hours)	43	43
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Note To Reviewer - ATUS 2017 Leave Questions	Note to Reviewer - ATUS Leave Module.docx	03/10/2016

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