Information Collection Request

Retaining Employment and Talent after Injury/Illness Network (RETAIN) Demonstration Projects and Evaluation

ICR 202506-1230-001 · OMB 1230-0014 · Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
RETAIN Statement A - Extension.docx Supporting Statement A Uploaded 2025-06-17 Available
RETAIN Statement A - Extension.docx Supporting Statement A Uploaded 2025-06-17 Repair queued
PRA Signature Form_RETAIN extension package_5-30-2025.pdf Supplementary Document Uploaded 2025-06-16 Available
PRA Signature Form_RETAIN extension package_5-30-2025.pdf Supplementary Document Uploaded 2025-06-16 Repair queued
2025-06262.pdf Supplementary Document Uploaded 2025-06-13 Available
2025-06262.pdf Supplementary Document Uploaded 2025-06-13 Repair queued
RETAIN Statement B - Extension.docx Supporting Statement B Uploaded 2025-06-13 Available
RETAIN Statement B - Extension.docx Supporting Statement B Uploaded 2025-06-13 Repair queued

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
235436 Retaining Employment and Talent after Injury/Illness Network (RETAIN) Demonstration Projects and Evaluation Other-Survey Modified

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
07/31/2028 36 Months From Approved 07/31/2025
150 0 5,313
50 0 1,771
0 0 0





Reginfo record details
1
table that charts list of burden
IC Title Form No. Form Name
Retaining Employment and Talent after Injury/Illness Network (RETAIN) Demonstration Projects and Evaluation

table that charts list of burden
  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 150 5,313 0 -5,163 0 0
Annual Time Burden (Hours) 50 1,771 0 -1,721 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No