Information Collection

Sleep Activity Diary

IC 236930 under ICR 202009-0920-025 · OMB 0920-1278.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-1278 can be found here:

Documents and Forms

Document Name Document Type
Form 0920- Sleep Activity Diary Form and Instruction
0920- Appx C1_Confidential Sleep/Wake Diary Appendix C1-7_Survey and Diary_(WORD).docx Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Sleep Activity Diary	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 C1_Confidential Sleep/Wake Diary	Appendix C1-7_Survey and Diary_(WORD).docx		Yes	Yes	Fillable Fileable

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	Previously Approved
Annual Number of Responses for this IC	5,040	5,040
Annual IC Time Burden (Hours)	84	84
Annual IC Cost Burden (Dollars)	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.