Information Collection

Workplace and Organizational Performance Survey

IC 228336 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⚠️ Notice: This information collection may be referencing outdated material.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
Form 1 Workplace and Organizational Performance Survey	Form and Instruction
1 Workplace Organizational Performance Survey Org Perform Survey_6.pdf	Form and Instruction
OMB Request for Approval - WP and Org Performance Survey_2017-0914.pdf Workplace and Organizational Performance Survey	IC Document

IC Title:

Workplace and Organizational Performance 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
Form and Instruction	1	Workplace Organizational Performance Survey	Org Perform Survey_6.pdf		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 708

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	708	708
Annual IC Time Burden (Hours)	177	177
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Workplace and Organizational Performance Survey	OMB Request for Approval - WP and Org Performance Survey_2017-0914.pdf	09/15/2017

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