Family and Medical Leave Act, Wave 4 Surveys

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Justification for Non-substantive Change FMLA 072919.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2019-07-30	Available
FMLA Wave 3 Survey NonResponse Bias Analysis_021318.docx	Supplementary Document	Uploaded 2018-02-13	Available
FMLA 4 Surveys 30 Day Notice_DOL responses to public comments_10-16-2017.docx	Supplementary Document	Uploaded 2017-12-04	Available
FMLA4_Employer_Job aid _11_2_2017.docx	Supplementary Document	Uploaded 2017-11-29	Available
FMLA4_Employee_Job aid_11_2_2017.docx	Supplementary Document	Uploaded 2017-11-29	Available
FMLA Wave 4 Surveys_OMB Part A_7.25.2017.docx	Supporting Statement A	Uploaded 2017-07-25	Available
FMLA 4 Attachment H Institutional_Review_Board_Notice_of_Approval_study_modification_2016.pdf	Supplementary Document	Uploaded 2017-06-29	Available
signed Part B review April 2017.pdf	Supplementary Document	Uploaded 2017-04-12	Available
FMLA Wave 4 Surveys_OMB Attachment G_Weighting and Estimation Procedures_3-17-17.docx	Supplementary Document	Uploaded 2017-04-03	Available
FMLA Wave 4 Surveys_OMB Attachment F_Privacy Statement_3-17-17.docx	Supplementary Document	Uploaded 2017-04-03	Available
FMLA Wave 4 Surveys_OMB Attachment E_Public Comments and DOL Responses_3-17-17.docx	Supplementary Document	Uploaded 2017-04-03	Available
FMLA Wave 4 Surveys_OMB Attachment D_Federal Register Notice.pdf	Supplementary Document	Uploaded 2017-04-03	Available
FMLA Wave 4 Surveys_OMB Attachment C_Advance Letter to Employers_3-17-17.doc	Supplementary Document	Uploaded 2017-04-03	Available
FMLA Wave 4 Surveys_OMB Part B_7.25.2017.docx	Supporting Statement B	Uploaded 2017-07-25	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
226268	Employer Extended Interview	Other-Employer Interview Guide	Unchanged
226267	Employer Screener Survey	Other-Employer Screener Survey	Unchanged
226266	Employee Non-Response Follow-up Survey	Other-Employee non-response survey	Unchanged
226265	Employee Extended Interview	Other-Employee Interview Guide	Unchanged
226163	Employee Screener Survey	Other-Survey	Unchanged

ICR Details

OMB Control No: 1290-0015	ICR Reference No: 201907-1290-001
Status: Active	Previous ICR Reference No: 201703-1290-001
Agency/Subagency: DOL/OS	Agency Tracking No:
Title: Family and Medical Leave Act, Wave 4 Surveys
Type of Information Collection: No material or nonsubstantive change to a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 09/17/2019
	Date Received in OIRA: 09/12/2019
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	02/28/2021	02/28/2021	02/28/2021
Responses	14,075	0	14,075
Time Burden (Hours)	1,504	0	1,504
Cost Burden (Dollars)	0	0	0

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Abstract: This ICR seeks PRA authority for the Family and Medical Leave Act (FMLA), Wave 4 Surveys information collection to study the FMLA by conducting a fourth 'wave' of nationally representative surveys of employees and employers covered by the provisions of FMLA. The survey findings will update and expand upon the knowledge gained from the earlier survey waves.

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Authorizing Statute(s): PL: Pub.L. 114 - 113 Div. H., Title I, sec. 107 Name of Law: Consolidated Appropriations Act, 2016
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	81 FR 75161	10/28/2016
30-day Notice:	Federal Register Citation:	Citation Date:
	82 FR 41660	09/01/2017
Did the Agency receive public comments on this ICR? Yes

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Number of Information Collection (IC) in this ICR: 5

table that charts list of burden

IC Title	Form No.	Form Name
Employer Screener Survey
Employee Non-Response Follow-up Survey
Employee Extended Interview
Employer Extended Interview
Employee Screener Survey

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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	14,075	14,075	0	0	0	0
Annual Time Burden (Hours)	1,504	1,504	0	0	0	0
Annual Cost Burden (Dollars)	0	0	0	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.

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Annual Cost to Federal Government: $1,082,516

Does this IC contain surveys, censuses, or employ statistical methods? Yes Part B of Supporting Statement

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     No

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     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: 09/12/2019

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