Information Collection

Multiple Worksite Report (Voluntary)

IC 178402 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⚠️ Notice: This information collection may be referencing outdated material.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 - Vol Multiple Worksite Report (Voluntary)	Form and Instruction
BLS 3020 MWR - Vol BLS 3020 Multiple Worksite Report - Voluntary MWR Form - Voluntary.pdf	Form and Instruction
BLS 3020 MWR - Vol BLS 3020 Multiple Worksite Report - Voluntary MWR Form - Voluntary.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 - Voluntary.pdf BLS 3020 MWR Cover Letter - Voluntary	IC Document
MWR Cover Letter - Voluntary.pdf BLS 3020 MWR Cover Letter - Voluntary	IC Document
MWR Web Letter - Voluntary.pdf BLS 3020 MWRWeb Cover Letter - Voluntary	IC Document
MWR Web Letter - Voluntary.pdf BLS 3020 MWRWeb Cover Letter - Voluntary	IC Document
MWRweb_Email_Reminders-Template.docx BLS 3020 MWRWeb Email Reminders	IC Document
MWRweb_Email_Reminders-Template.docx BLS 3020 MWRWeb Email Reminders	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_Voluntary_2022.docx MWR Breakout Letter - Voluntary	IC Document
MWR_Breakout_Letter_Template_Voluntary_2022.docx MWR Breakout Letter - Voluntary	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 (Voluntary)

Agency IC Tracking Number:

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	BLS 3020 MWR - Voluntary	BLS 3020 Multiple Worksite Report - Voluntary	MWR Form - Voluntary.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: 55,803

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

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

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	223,212	-10,180	233,392
Annual IC Time Burden (Hours)	82,588	-3,767	86,355
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 - Voluntary	MWR Cover Letter - Voluntary.pdf	04/14/2022
BLS 3020 MWRWeb Cover Letter - Voluntary	MWR Web Letter - Voluntary.pdf	04/14/2022
BLS 3020 MWRWeb Email Reminders	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 - Voluntary	MWR_Breakout_Letter_Template_Voluntary_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.