Information Collection

Actigraphy watch Fitting

IC 254320 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⚠️ Notice: This information collection may be referencing outdated material.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

Documents and forms in this information collection
Document Name	Document Type
Attachment J.docx	Other-Actigraphy watch fitting
Attachment J.docx	Other-Actigraphy watch fitting

IC Title:

Actigraphy watch Fitting

Agency IC Tracking Number:

0920-21FC

Is this a Common Form? Yes

IC Status: New

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
Other-Actigraphy watch fitting			Attachment J.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: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	50	50
Annual IC Time Burden (Hours)	23	23
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
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.