Information Collection

Interviews with Restaurant Owners about Knowledge and Attitudes towards Work-Related Musculoskeletal Disorders Prevention

IC 226270 under ICR 201501-0920-025 · OMB 0920-0940.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Interview Script 4_5_17.docx	Other-Interview Script
Screener Recruitment Screener.docx	Form
OMB Request 4_5_17.docx Request for Approval	IC Document

IC Title:

Agency IC Tracking Number:

17ACF

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-Interview Script			Interview Script 4_5_17.docx		Yes	No	Paper Only
Form	none	Screener	Recruitment Screener.docx		No		Paper Only

Line of Business: Workforce Management

Subfunction: Worker Safety

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 200

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	200	200
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
Request for Approval	OMB Request 4_5_17.docx	04/06/2017

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