Government Contractor Paid Sick Leave

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
SS1235-0029 9-30 CLEAN.docx	Supporting Statement A	Uploaded 2016-09-30	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
222577	Regulatory Familiarization		New
219209	Notice of Accrued Leave Other		Modified
219208	Notice of Accrued Leave per use		Removed
219207	Denial of Leave		Modified
219206	Pay period / Monthly Notice		Modified
219205	Record of Cash-out		Modified
219204	Paid Sick Leave Record Designation		Modified
219203	Certification Paid Sick Leave		Modified

ICR Details

OMB Control No: 1235-0029	ICR Reference No: 201607-1235-001
Status: Historical Active	Previous ICR Reference No: 201512-1235-002
Agency/Subagency: DOL/WHD	Agency Tracking No:
Title: Government Contractor Paid Sick Leave
Type of Information Collection: New collection (Request for a new OMB Control Number)	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 12/21/2016
	Date Received in OIRA: 09/30/2016
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	12/31/2019	36 Months From Approved
Responses	13,577,407	0	0
Time Burden (Hours)	590,477	0	0
Cost Burden (Dollars)	347,784	0	0

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Abstract: This ICR implements the information collections associated with Executive Order 13706, Paid Sick Leave for Federal Contractors.

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Authorizing Statute(s): EO: EO 13706 Name/Subject of EO: Paid Sick Leave for Federal Contractors
  

Citations for New Statutory Requirements: EO: EO 13706 Name/Subject of EO: Establishing Paid Sick Leave for Federal Contractors

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
1235-AA13	Final or interim final rulemaking	81 FR 67598	09/30/2016

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	81 FR 9592	02/25/2016
30-day Notice:	Federal Register Citation:	Citation Date:
	81 FR 9592	02/25/2016
Did the Agency receive public comments on this ICR? Yes

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Number of Information Collection (IC) in this ICR: 7

table that charts list of burden

IC Title	Form No.	Form Name
Paid Sick Leave Record Designation
Record of Cash-out
Pay period / Monthly Notice
Denial of Leave
Certification Paid Sick Leave
Regulatory Familiarization
Notice of Accrued Leave Other
Notice of Accrued Leave per use

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ICR Summary of Burden

table that charts list of burden

	Total Approved	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	13,577,407	0	13,577,407	0	0	0
Annual Time Burden (Hours)	590,477	0	590,477	0	0	0
Annual Cost Burden (Dollars)	347,784	0	347,784	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: This is a new information collection related to the implementing regulations for Executive Order 13706, Establishing Paid Sick Leave for Federal Contractors.

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Annual Cost to Federal Government: $0

Does this IC contain surveys, censuses, or employ statistical methods? No

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 09/30/2016

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