Information Collection

Family anad Medical Leave Act Forms Comment Card

IC 230546 under ICR 201701-1225-001 · OMB 1225-0088.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1225-0088 can be found here:

Documents and Forms

Document Name Document Type
Forms questions DMEC.docx Other-Form Questions
Generic_Clearance_Submission_FMLA Comment Card 20180306.docx FMLA Comment Card Supplemental Document IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Family anad Medical Leave Act Forms Comment Card	Agency IC Tracking Number:

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
Other-Form Questions			Forms questions DMEC.docx		No		Printable Only

Line of Business: Workforce Management

Subfunction: Labor Rights Management

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 300	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	300	300
Annual IC Time Burden (Hours)	50	50
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
FMLA Comment Card Supplemental Document	Generic_Clearance_Submission_FMLA Comment Card 20180306.docx	03/06/2018

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