Information Collection

Driver SF-36v2

IC 242909 under ICR 202006-0920-016 · OMB 0920-1338.

Documents and Forms

Document Name Document Type
Driver SF-36v2 Form and Instruction
Short Form -36 Version 2 (SF-36v2) Att. O Short Form -36 Version 2 (SF-36v2; waves 1-4).docx Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Driver SF-36v2	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	n/a	Short Form -36 Version 2 (SF-36v2)	Att. O Short Form -36 Version 2 (SF-36v2; waves 1-4).docx		Yes	Yes	Fillable Fileable

Line of Business: Workforce Management

Subfunction: Worker Safety

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 90	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 100 %

	Requested	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	360	360
Annual IC Time Burden (Hours)	180	180
Annual IC Cost Burden (Dollars)	3,870	3,870

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.