Hardcopy Survey Sections

Work Organization Risks to Short-haul Truck Drivers’ Health & Safety

Documents and Forms

Document Name Document Type
Form 092-20BY Hardcopy Survey Sections Form
092-20BY AttachmentK_LSH_RespondentScreeningForm AttachmentK_LSH_RespondentScreeningForm_Sept18.docx Form
092-20BY AttachmentK_LSH_RespondentScreeningForm AttachmentK_LSH_RespondentScreeningForm_Sept18.docx Form

Information Collection (IC) Details

IC Title:	Hardcopy Survey Sections	Agency IC Tracking Number:	0920-20BY

Is this a Common Form? Yes		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
Form	092-20BY	AttachmentK_LSH_RespondentScreeningForm	AttachmentK_LSH_RespondentScreeningForm_Sept18.docx		No		Fillable Fileable

Line of Business: Workforce Management

Subfunction: Worker Safety

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 297	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	297	297
Annual IC Time Burden (Hours)	149	149
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.