Information Collection

Employee Screener Survey

IC 226163 under ICR 201907-1290-001 · OMB 1290-0015.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
FMLA Wave 4 Surveys_OMB Attachment A.1_Employee Screener Survey_7.25.17.docx	Other-Survey

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Unchanged

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Survey			FMLA Wave 4 Surveys_OMB Attachment A.1_Employee Screener Survey_7.25.17.docx		No		Printable Only

Line of Business: Workforce Management

Subfunction: Labor Rights Management

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 8,864

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	8,864	8,864
Annual IC Time Burden (Hours)	295	295
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
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.