Employer Long-Form Survey

Demonstration and Evaluation of the Short-Time Compensation Program

Documents and Forms

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

Information Collection (IC) Details

IC Title:	Employer Long-Form Survey	Agency IC Tracking Number:

Is this a Common Form? No		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
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 %

	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

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.