OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

Last Symptom Check and Return to Work Clearance (food and nonfood employees)

IC 252606 under ICR 202603-0920-012 · OMB 0920-1260.

Documents and Forms
Document Name
Document Type
Form and Instruction
Form and Instruction
Information Collection (IC) Details

View Information Collection (IC)

Last Symptom Check and Return to Work Clearance (food and nonfood employees) 0920-1260
 
No Modified
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction 0920-1260 Last Symptom Check and Return to Work Clearance (food and nonfood employees) Att5f LastSymptomCheck ReturnWorkClrnce (non-standard) 20220125.docx Yes Yes Fillable Fileable

Health Illness Prevention

 

18,000 0
   
Private Sector Businesses or other for-profits, Not-for-profit institutions
 
   0 %

  Requested Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 18,000 0 750 0 0 17,250
Annual IC Time Burden (Hours) 900 0 38 0 0 862
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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.
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