Information Collection

[OPHDST] WAI Learning Community Survey

IC 273678 under ICR 202505-0920-006 · OMB 0920-1050.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-1050 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 0920-25CS [OPHDST] WAI Learning Community Survey	Form
Form 0920-25CS WAI Learning Community Survey [OPHDST] WAI Learning Community Survey	Form
0920-25CS WAI Learning Community Survey Att A WAI Learning Community Survey.docx	Form
0920-25CS WAI Learning Community Survey Att A WAI Learning Community Survey.docx	Form
Template WAI Learning Community.docx GenIC Request	IC Document
Template WAI Learning Community.docx GenIC Request	IC Document
SSA WAI Learning Community.docx SSA	IC Document
SSA WAI Learning Community.docx SSA	IC Document

IC Title:

[OPHDST] WAI Learning Community Survey

Agency IC Tracking Number:

0920-1050-25CS

IC Status: Unchanged

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	0920-25CS				Yes	Yes	Fillable Fileable

Line of Business: Workforce Management

Subfunction: Worker Safety

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 60

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Requested	Previously Approved
Annual Number of Responses for this IC	60	60
Annual IC Time Burden (Hours)	20	20
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
GenIC Request		01/15/2025
SSA		01/15/2025

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

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