Information Collection

Multiple Worksite Report (Mandatory)

IC 178400 under ICR 202204-1220-002 · OMB 1220-0134.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1220-0134 can be found here:

2025-09-16 - Extension without change of a currently approved collection

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form BLS 3020 MWR - Man Multiple Worksite Report (Mandatory)	Form and Instruction
BLS 3020 MWR - Man BLS 3020 Multiple Worksite Report - Mandatory MWR Form - Mandatory.pdf	Form and Instruction
BLS 3020 MWR - Man BLS 3020 Multiple Worksite Report - Mandatory MWR Form - Mandatory.pdf	Form and Instruction
BLS 3020 MWRWeb BLS 3020 MWRWeb MWR_Web_Screenshots_2022.pdf	Form and Instruction
BLS 3020 MWRWeb BLS 3020 MWRWeb MWR_Web_Screenshots_2022.pdf	Form and Instruction
MWR Cover Letter - Mandatory.pdf BLS 3020 MWR Cover Letter - Mandatory	IC Document
MWR Cover Letter - Mandatory.pdf BLS 3020 MWR Cover Letter - Mandatory	IC Document
MWR Web Letter - Mandatory.pdf BLS 3020 MWRWeb Cover Letter - Mandatory	IC Document
MWR Web Letter - Mandatory.pdf BLS 3020 MWRWeb Cover Letter - Mandatory	IC Document
MWRweb_Email_Reminders-Template.docx BLS 3020 MWRWeb Reminder Emails	IC Document
MWRweb_Email_Reminders-Template.docx BLS 3020 MWRWeb Reminder Emails	IC Document
MWRWeb_File_Upload_Letter.docx BLS 3020 MWRWeb FIle Upload Cover Letter	IC Document
MWRWeb_File_Upload_Letter.docx BLS 3020 MWRWeb FIle Upload Cover Letter	IC Document
MWRweb_Intro_Emails-Template.docx BLS 3020 MWRWeb Email Solicitation Templates	IC Document
MWRweb_Intro_Emails-Template.docx BLS 3020 MWRWeb Email Solicitation Templates	IC Document
MWR_Breakout_Letter_Template_Mandatory_2022.docx MWR Breakout Letter - Mandatory	IC Document
MWR_Breakout_Letter_Template_Mandatory_2022.docx MWR Breakout Letter - Mandatory	IC Document
MWR_Breakout_Email_Blast_Template_2022.docx MWR Breakout Email Blast	IC Document
MWR_Breakout_Email_Blast_Template_2022.docx MWR Breakout Email Blast	IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:

Multiple Worksite Report (Mandatory)

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Mandatory

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	BLS 3020 MWR - Mandatory	BLS 3020 Multiple Worksite Report - Mandatory	MWR Form - Mandatory.pdf		Yes	Yes	Fillable Printable
Form and Instruction	BLS 3020 MWRWeb	BLS 3020 MWRWeb	MWR_Web_Screenshots_2022.pdf		Yes	Yes	Fillable Fileable

Federal Enterprise Architecture Business Reference Module

Line of Business: General Government

Subfunction: Central Records & Statistical Mgt

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 90,924

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 59 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	363,696	19,052	344,644
Annual IC Time Burden (Hours)	134,568	7,050	127,518
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
BLS 3020 MWR Cover Letter - Mandatory	MWR Cover Letter - Mandatory.pdf	04/14/2022
BLS 3020 MWRWeb Cover Letter - Mandatory	MWR Web Letter - Mandatory.pdf	04/14/2022
BLS 3020 MWRWeb Reminder Emails	MWRweb_Email_Reminders-Template.docx	07/07/2022
BLS 3020 MWRWeb FIle Upload Cover Letter	MWRWeb_File_Upload_Letter.docx	07/07/2022
BLS 3020 MWRWeb Email Solicitation Templates	MWRweb_Intro_Emails-Template.docx	07/07/2022
MWR Breakout Letter - Mandatory	MWR_Breakout_Letter_Template_Mandatory_2022.docx	08/18/2022
MWR Breakout Email Blast	MWR_Breakout_Email_Blast_Template_2022.docx	08/18/2022

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.