Information Collection

Workstyle Survey

IC 224420 under ICR 201501-0925-004 · OMB 0925-0648.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0925-0648 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
NIH_Rockledge_WorkstyleSurveyEmail_DRAFT_11-14-16.docx	Other-Survey Email
1 Qualtrics Print Qualtrics Print 11-15-16.pdf	Form and Instruction
NIH Workstyle Survey Fast-track template 2016-mods1.doc Workstyle Survey	IC Document

IC Title:

Workstyle Survey

Agency IC Tracking Number:

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 Email			NIH_Rockledge_WorkstyleSurveyEmail_DRAFT_11-14-16.docx		Yes	Yes	Fillable Fileable
Form and Instruction	1	Qualtrics Print	Qualtrics Print 11-15-16.pdf		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 300

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	300	300
Annual IC Time Burden (Hours)	30	30
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Workstyle Survey	NIH Workstyle Survey Fast-track template 2016-mods1.doc	11/15/2016

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