Information Collection

Retaining Employment and Talent After Injury/Illness Network (RETAIN) Grants

IC 231507 under ICR 201601-1225-005 · OMB 1225-0086.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1225-0086 can be found here:

Documents and Forms

Document Name Document Type
RETAIN FOA_2018-05-04_clean.docx www.Grants.gov and www.doleta.gov/grants/find_grants.cfm Other-FOA
RETAIN Grants Supplementary Statement.docx RETAIN Grants Supplementary Justification IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Retaining Employment and Talent After Injury/Illness Network (RETAIN) Grants	Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-FOA			RETAIN FOA_2018-05-04_clean.docx	www.Grants.gov and https://www.doleta.gov/grants/find_grants.cfm	Yes	Yes	Fillable Fileable

Line of Business: Workforce Management

Subfunction: Worker Safety

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 10	Number of Respondents for Small Entity: 10

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	10	10
Annual IC Time Burden (Hours)	200	200
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
RETAIN Grants Supplementary Justification	RETAIN Grants Supplementary Statement.docx	05/18/2018

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