Information Collection

Employer Long-Form Survey

IC 215997 under ICR 201504-1291-002 · OMB 1291-0005.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 3 Employer Long-Form Survey	Form and Instruction
3 Iowa Employer Long-Form Survey 201504-1291-002_Iowa Survey LF_2015-10-01_clean_final.docx	Form and Instruction
4 Oregon Long-Form Employer Survey 201504-1291-002_Oregon Survey LF_2015-10-01_clean_final.docx	Form and Instruction
Oregon Survey LF 2-24-2015.docx Oregon- Invitation letter to participate in web-based long-form survey	IC Document
Invitation letter Iowa 2_25_15-LF.docx Iowa- Invitation letter to participate in web-based long-form survey	IC Document

IC Title:

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	3	Iowa Employer Long-Form Survey	201504-1291-002_Iowa Survey LF_2015-10-01_clean_final.docx		Yes	Yes	Fillable Fileable
Form and Instruction	4	Oregon Long-Form Employer Survey	201504-1291-002_Oregon Survey LF_2015-10-01_clean_final.docx		Yes	Yes	Fillable Fileable

Line of Business: Economic Development

Subfunction: Business and Industry Development

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 800

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

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	800	800
Annual IC Time Burden (Hours)	160	160
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Oregon- Invitation letter to participate in web-based long-form survey	Oregon Survey LF 2-24-2015.docx	04/07/2015
Iowa- Invitation letter to participate in web-based long-form survey	Invitation letter Iowa 2_25_15-LF.docx	04/07/2015

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