Information Collection

National Worker Well-being Survey

IC 230660 under ICR 201803-0920-006 · OMB 0920-1234.

Documents and Forms

Document Name Document Type
National Worker Well-being Survey Form
National Worker Well-being Survey Att D Worker_WB_Survey_Revised.docx Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	National Worker Well-being Survey	Agency IC Tracking Number:	0920-17BM

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	National Worker Well-being Survey	Att D Worker_WB_Survey_Revised.docx		Yes	Yes	Fillable Fileable

Line of Business: Workforce Management

Subfunction: Worker Safety

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 1,025	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	1,025	1,025
Annual IC Time Burden (Hours)	342	342
Annual IC Cost Burden (Dollars)	7,937	7,937

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.