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Notice to Polygraph Examiner Identifying Persons to be Examined
Application of the Employee Polygraph Protection Act
OMB: 1235-0005
IC ID: 185476
OMB.report
DOL/WHD
OMB 1235-0005
ICR 202001-1235-001
IC 185476
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1235-0005 can be found here:
2023-09-08 - Extension without change of a currently approved collection
Documents and Forms
Document Name
Document Type
no available documents/forms check other ICs listed under this ICR
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Notice to Polygraph Examiner Identifying Persons to be Examined
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Unchanged
Obligation to Respond:
Mandatory
CFR Citation:
29 CFR 801.30(a)(5)
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Federal Enterprise Architecture Business Reference Module
Line of Business:
Workforce Management
Subfunction:
Labor Rights Management
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
82,000
Number of Respondents for Small Entity:
77,080
Affected Public:
Private Sector
Private Sector:
Businesses or other for-profits, Farms, Not-for-profit institutions
Percentage of Respondents Reporting Electronically:
0 %
Approved
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
164,000
0
0
0
0
164,000
Annual IC Time Burden (Hours)
16,400
0
0
0
0
16,400
Annual IC Cost Burden (Dollars)
0
0
0
0
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.