Information Collection

EPA Workforce Questionnaire on Returning to the Workplace

IC 247539 under ICR 202105-2030-001 · OMB 2030-0050.

Documents and Forms

Document Name Document Type
Employee Survey_5-20-2021 (002).pdf Other-Questionnaire

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	EPA Workforce Questionnaire on Returning to the Workplace	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
Other-Questionnaire			Employee Survey_5-20-2021 (002).pdf		Yes	Yes	Fillable Fileable

Line of Business: Workforce Management

Subfunction: Worker Safety

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 18,000	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	18,000	18,000
Annual IC Time Burden (Hours)	4,500	4,500
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.