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⚠️ Notice: This information collection may be referencing outdated material.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

Documents and forms in this information collection
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

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:

table that charts list of 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 %

table that charts list of burden
	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

table that charts IC Documents
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.