Information Collection

Initial Meeting (Fit Actigraph)

IC 236665 under ICR 202012-0920-008 · OMB 0920-1278.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Initial Meeting (Fit Actigraph)	Form and Instruction
C1 - Initial meeting Appendix C- surveys and diaries (1).docx	Form and Instruction
C1 - Initial meeting Appendix C- surveys and diaries (1).docx	Form and Instruction

IC Title:

Agency IC Tracking Number:

0920-1278

Is this a Common Form? No

IC Status: Modified

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	na	C1 - Initial meeting	Appendix C- surveys and diaries (1).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 %

table that charts list of burden
	Approved	Change Due to Potential Violation of the PRA
Annual Number of Responses for this IC	60	60
Annual IC Time Burden (Hours)	15	15
Annual IC Cost Burden (Dollars)	0	0

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.