Information Collection

Multiple Worksite Report (Mandatory)

IC 178400 under ICR 202003-1220-002 · OMB 1220-0134.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1220-0134 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form BLS 3020 MWR - Man Multiple Worksite Report (Mandatory)	Form and Instruction
BLS 3020 MWR - Man BLS 3020 Multiple Worksite Report - Mandatory BLS-3020-MWR_Mandatory.pdf	Form and Instruction
BLS 3020 MWRWeb BLS 3020 MWRWeb BLS-3020-MWRWeb_Screenshots.pdf	Form and Instruction
BLS-3020-MWR_Cover_Letter_(Print)_Mandatory.doc BLS 3020 MWR Cover Letter - Mandatory	IC Document
BLS-3020-MWR_Cover_Letter_(Web)_Mandatory.docx BLS 3020 MWRWeb Cover Letter - Mandatory	IC Document
BLS-3020-MWRweb_Email_Reminders.docx BLS 3020 MWRWeb Email Reminders	IC Document
BLS-3020-MWRWeb_File_Upload_Letter.docx BLS 3020 MWRWeb FIle Upload Cover Letter	IC Document
MWR_Email_Solicitation_Templates.docx MWR Email Solicitation Templates	IC Document

IC Title:

Multiple Worksite Report (Mandatory)

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Mandatory

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
Form and Instruction	BLS 3020 MWR - Mandatory	BLS 3020 Multiple Worksite Report - Mandatory	BLS-3020-MWR_Mandatory.pdf		Yes	Yes	Fillable Printable
Form and Instruction	BLS 3020 MWRWeb	BLS 3020 MWRWeb	BLS-3020-MWRWeb_Screenshots.pdf		Yes	Yes	Fillable Fileable

Line of Business: General Government

Subfunction: Central Records & Statistical Mgt

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 86,161

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

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

Percentage of Respondents Reporting Electronically: 56 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	344,644	344,644
Annual IC Time Burden (Hours)	127,518	127,518
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
BLS 3020 MWR Cover Letter - Mandatory	BLS-3020-MWR_Cover_Letter_(Print)_Mandatory.doc	05/14/2019
BLS 3020 MWRWeb Cover Letter - Mandatory	BLS-3020-MWR_Cover_Letter_(Web)_Mandatory.docx	05/14/2019
BLS 3020 MWRWeb Email Reminders	BLS-3020-MWRweb_Email_Reminders.docx	05/14/2019
BLS 3020 MWRWeb FIle Upload Cover Letter	BLS-3020-MWRWeb_File_Upload_Letter.docx	05/14/2019
MWR Email Solicitation Templates	MWR_Email_Solicitation_Templates.docx	03/19/2020

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.