Information Collection

Department of Labor Generic Clearance for the Job Accommodation Network (JAN) Customer Satisfaction Survey

IC 233497 under ICR 201601-1225-004 · OMB 1225-0059.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1225-0059 can be found here:

Documents and Forms

Document Name Document Type
JAN Employer Survey 9-14-2018Final.pdf wvu.qualtrics.com/jfe/form/SV_0CVOb1ZRfXomvTD Other-Survey
JAN Individual Survey 9-14-2018Final.pdf wvu.qualtrics.com/jfe/form/SV_e5O8cfaUNccBHrD Other-Survey
JAN Self-Employment Survey 9-14-2018Final.pdf wvu.qualtrics.com/jfe/form/SV_ezczKAwKndM2ge1 Other-Survey
JAN Professional Survey 9-14-2018Final.pdf wvu.qualtrics.com/jfe/form/SV_blQuFjs0Po0tMJT Other-Survey
Script for informed consent to participate in JAN customer satisfaction survey.docx Script for informed consent to participate in JAN customer satisfaction survey IC Document
WVU JAN Customer Satisfaction Budget Option year 1_2_3..xlsx WVU JAN Customer Satisfaction Budget Option year 1_2_3. IC Document
JAN survey Email introductionFinal 10.09.18.docx Email Introduction IC Document
1225-0059 Supplemental Supporting Statement_.docx Mini-Supporting Statement 11-2018 IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Department of Labor Generic Clearance for the Job Accommodation Network (JAN) Customer Satisfaction Survey	Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Survey	JAN Employer Survey 9-14-2018Final.pdf	https://wvu.qualtrics.com/jfe/form/SV_0CVOb1ZRfXomvTD	Yes	Yes	Fillable Fileable
Other-Survey	JAN Individual Survey 9-14-2018Final.pdf	https://wvu.qualtrics.com/jfe/form/SV_e5O8cfaUNccBHrD	Yes	Yes	Fillable Fileable
Other-Survey	JAN Self-Employment Survey 9-14-2018Final.pdf	https://wvu.qualtrics.com/jfe/form/SV_ezczKAwKndM2ge1	Yes	Yes	Fillable Fileable
Other-Survey	JAN Professional Survey 9-14-2018Final.pdf	https://wvu.qualtrics.com/jfe/form/SV_blQuFjs0Po0tMJT	Yes	Yes	Fillable Fileable

Line of Business: Workforce Management

Subfunction: Labor Rights Management

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 15,000	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	15,000	15,000
Annual IC Time Burden (Hours)	3,750	3,750
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Script for informed consent to participate in JAN customer satisfaction survey	Script for informed consent to participate in JAN customer satisfaction survey.docx	10/12/2018
WVU JAN Customer Satisfaction Budget Option year 1_2_3.	WVU JAN Customer Satisfaction Budget Option year 1_2_3..xlsx	10/12/2018
Email Introduction	JAN survey Email introductionFinal 10.09.18.docx	11/05/2018
Mini-Supporting Statement 11-2018	1225-0059 Supplemental Supporting Statement_.docx	11/05/2018

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