EFMLEA Employer Record (State/local/tribal)

Paid Leave Under the Families First Coronavirus Response Act

Documents and Forms

Document Name Document Type

no available documents/forms check other ICs listed under this ICR

Information Collection (IC) Details

IC Title:	EFMLEA Employer Record (State/local/tribal)	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 29 CFR 826.100 29 CFR 826.140

Information Collection 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: 114,876	Number of Respondents for Small Entity: 50

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 70 %

	Requested	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	134,484	23,982	110,502
Annual IC Time Burden (Hours)	2,802	500	2,302
Annual IC Cost Burden (Dollars)	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.