Information Collection

Paid Sick Leave Notice of Need for Leave (private)

IC 240980 under ICR 202005-1235-003 · OMB 1235-0031.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type

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IC Title:

Paid Sick Leave Notice of Need for Leave (private)

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Unchanged

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 29 CFR 826.90 29 CFR 826.100

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

Line of Business: Workforce Management

Subfunction: Labor Rights Management

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 950,000

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

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

Percentage of Respondents Reporting Electronically: 80 %

table that charts list of burden
	Requested	Previously Approved
Annual Number of Responses for this IC	950,000	950,000
Annual IC Time Burden (Hours)	31,667	31,667
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
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Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.