Information Collection

Discussion Guide

IC 213745 under ICR 201411-0920-003 · OMB 0920-1060.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Discussion Guide	Form and Instruction
Discussion Guide Attachment I_Discussion Guide.docx	Form and Instruction
Attachment G_Interview Confirmation Email_EH.docx G - Confirmation Email	IC Document
Attachment H_Interview Opening Statement.docx H - Interview Opening Statement	IC Document
Attachment J_Interview Thank You Email.docx J - Thank you Email	IC Document

IC Title:

Discussion Guide

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
Form and Instruction	none	Discussion Guide	Attachment I_Discussion Guide.docx		No		Paper Only

Line of Business: Workforce Management

Subfunction: Worker Safety

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 28

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

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	28	28
Annual IC Time Burden (Hours)	14	14
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
G - Confirmation Email	Attachment G_Interview Confirmation Email_EH.docx	11/05/2014
H - Interview Opening Statement	Attachment H_Interview Opening Statement.docx	11/05/2014
J - Thank you Email	Attachment J_Interview Thank You Email.docx	11/05/2014

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