Information Collection

Driver SF-36v2

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

Documents and Forms

Documents and forms in this information collection
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

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:

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	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 %

table that charts list of burden
	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

table that charts IC Documents
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.