OMB
.report
Search
Pittsburgh Sleep Quality Index (App Ca_Sleep Activity Dairy Surveys)
Online Training for Law Enforcement to Reduce Risks Associated withShift Work and Long Work Hours
OMB: 0920-1278
IC ID: 236928
OMB.report
HHS/CDC
OMB 0920-1278
ICR 202009-0920-025
IC 236928
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-1278 can be found here:
2021-01-15 - Reinstatement with change of a previously approved collection
Documents and Forms
Document Name
Document Type
Form 0920-
Pittsburgh Sleep Quality Index (App Ca_Sleep Activity Dairy Surveys)
Form and Instruction
0920- Appx C5_Pittsburgh Sleep Quality Index Surveys
Appendix C1-7_Survey and Diary_(WORD).docx
Form and Instruction
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Pittsburgh Sleep Quality Index (App Ca_Sleep Activity Dairy Surveys)
Agency IC Tracking Number:
0920-17BBV
Is this a Common Form?
No
IC Status:
Unchanged
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
0920-
Appx C5_Pittsburgh Sleep Quality Index Surveys
Appendix C1-7_Survey and Diary_(WORD).docx
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Workforce Management
Subfunction:
Worker Safety
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
60
Number of Respondents for Small Entity:
0
Affected Public:
State, Local, and Tribal Governments
Percentage of Respondents Reporting Electronically:
100 %
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
120
0
0
0
0
120
Annual IC Time Burden (Hours)
4
0
0
0
0
4
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.