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Concurrent leave notice (private)
Paid Leave Under the Families First Coronavirus Response Act
OMB: 1235-0031
IC ID: 240993
OMB.report
DOL/WHD
OMB 1235-0031
ICR 202003-1235-002
IC 240993
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1235-0031 can be found here:
2020-09-22 - Revision 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:
Concurrent leave notice (private)
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
New
Obligation to Respond:
Required to Obtain or Retain Benefits
CFR Citation:
29 CFR 826.100
29 CFR 826.140
29 CFR 826.20
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:
4,750
Number of Respondents for Small Entity:
50
Affected Public:
Private Sector
Private Sector:
Businesses or other for-profits, Farms, Not-for-profit institutions
Percentage of Respondents Reporting Electronically:
70 %
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
4,750
0
4,750
0
0
0
Annual IC Time Burden (Hours)
159
0
159
0
0
0
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.