Information Collection

Self-Esscape Confidence Survey

IC 221801 under ICR 201606-0920-002 · OMB 0920-1135.

Documents and Forms

Document Name Document Type
Self-Esscape Confidence Survey Form
Self-Escape Confidence Survey rev Hoebbel_Perceived Self-Escape Competencies Survey_Revised 20160303.rtf Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Self-Esscape Confidence 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	none	Self-Escape Confidence Survey	rev Hoebbel_Perceived Self-Escape Competencies Survey_Revised 20160303.rtf		Yes	No	Paper Only

Line of Business: Workforce Management

Subfunction: Worker Safety

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 400	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	400	400
Annual IC Time Burden (Hours)	67	67
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

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