Information Collection

Consensus Sleep Diary

IC 254319 under ICR 202206-0920-011 · OMB 0920-1367.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-1367 can be found here:

Documents and Forms

Document Name Document Type
Form 0920-21FC Consensus Sleep Diary Form
0920-21FC Attachment E.Consensus Sleep Diary Attachment E.Consensus Sleep Diary.docx Form
0920-21FC Attachment E.Consensus Sleep Diary Attachment E.Consensus Sleep Diary.docx Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Consensus Sleep Diary	Agency IC Tracking Number:	0920-21FC

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	0920-21FC	Attachment E.Consensus Sleep Diary	Attachment E.Consensus Sleep Diary.docx		Yes	Yes	Fillable Fileable

Line of Business: Workforce Management

Subfunction: Worker Safety

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 50	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	50	50
Annual IC Time Burden (Hours)	70	70
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.