Employee Extended Interview

Family and Medical Leave Act, Wave 4 Surveys

Documents and Forms

Document Name Document Type
FMLA Wave 4 Surveys_OMB Attachment A.2_Employee Extended Interview_7.25.17.docx Other-Employee Interview Guide

Information Collection (IC) Details

IC Title:	Employee Extended Interview	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Unchanged

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
Other-Employee Interview Guide			FMLA Wave 4 Surveys_OMB Attachment A.2_Employee Extended Interview_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: 1,333	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Previously Approved
Annual Number of Responses for this IC	1,333	1,333
Annual IC Time Burden (Hours)	311	311
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.