Information Collection

Modifications

IC 198891 under ICR 202501-1210-003 · OMB 1210-0147.

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Documents and Forms

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IC Title:

Modifications

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Unchanged

Obligation to Respond: Mandatory

CFR Citation: 29 CFR 2590.715-2715

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

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 40,146

Number of Respondents for Small Entity: 34,927

Affected Public: Private Sector

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

Percentage of Respondents Reporting Electronically: 58 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	1,458,000	1,458,000
Annual IC Time Burden (Hours)	5,079	5,079
Annual IC Cost Burden (Dollars)	298,628	298,628

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
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Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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