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Application for Mediation Services
Application for Mediation Services
OMB: 3140-0002
IC ID: 32919
OMB.report
NMB
OMB 3140-0002
ICR 201706-3140-003
IC 32919
( )
Documents and Forms
Document Name
Document Type
MediationROCISForms.pdf
MediationROCISForms
IC Document
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Application for Mediation Services
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Modified
Obligation to Respond:
Voluntary
CFR Citation:
29 CFR 1203.1
29 CFR 1208.5
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Federal Enterprise Architecture Business Reference Module
Line of Business:
General Government
Subfunction:
Executive Functions
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
50
Number of Respondents for Small Entity:
0
Affected Public:
Federal Government
Percentage of Respondents Reporting Electronically:
0 %
Approved
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
50
0
0
0
50
0
Annual IC Time Burden (Hours)
12
0
0
0
12
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
MediationROCISForms
MediationROCISForms.pdf
06/20/2017
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
