Information Collection

Work Organization Risks to Short-haul Truck Drivers' Health & Safety (Survey)

IC 242170 under ICR 202003-0920-019 · OMB unassigned.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
AttachmentJ_LSH_CompanySurvey_Sept19.docx	Other-Company Survey
0920-20BY LHS Survey AttachmentC_LSHSurvey.docx	Form and Instruction

IC Title:

Agency IC Tracking Number:

0920-20BY

Is this a Common Form? No

IC Status: New

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-Company Survey			AttachmentJ_LSH_CompanySurvey_Sept19.docx		Yes	Yes	Fillable Fileable
Form and Instruction	0920-20BY	LHS Survey	AttachmentC_LSHSurvey.docx		Yes	Yes	Fillable Fileable

Line of Business: Workforce Management

Subfunction: Worker Safety

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 600

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Requested	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	600	600
Annual IC Time Burden (Hours)	173	173
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.