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

Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery (NIOSH)

Documents and Forms

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

Information Collection (IC) Details

IC Title:	Interviews with Restaurant Owners about Knowledge and Attitudes towards Work-Related Musculoskeletal Disorders Prevention	Agency IC Tracking Number:	17ACF

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection 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 %

	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

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.