Pittsburgh Sleep Quality Index (App Ca_Sleep Activity Dairy Surveys)

Online Training for Law Enforcement to Reduce Risks Associated withShift Work and Long Work Hours

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-1278 can be found here:

Documents and Forms

Document Name Document Type
Form 0920- Pittsburgh Sleep Quality Index (App Ca_Sleep Activity Dairy Surveys) Form and Instruction
Appendix G_Email Msg wLinks to Study Survey & Tng.docx Instruction
0920- Appx C5_Pittsburgh Sleep Quality Index Surveys Appendix C1-7_Survey and Diary_(WORD).docx Form and Instruction

Information Collection (IC) Details

IC Title:	Pittsburgh Sleep Quality Index (App Ca_Sleep Activity Dairy Surveys)	Agency IC Tracking Number:	0920-17BBV

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 and Instruction	0920-	Appx C5_Pittsburgh Sleep Quality Index Surveys	Appendix C1-7_Survey and Diary_(WORD).docx		Yes	Yes	Fillable Fileable
Instruction			Appendix G_Email Msg wLinks to Study Survey & Tng.docx		Yes	No	Paper Only

Line of Business: Workforce Management

Subfunction: Worker Safety

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 60	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	120	120
Annual IC Time Burden (Hours)	4	4
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.