Information Collection

Employee Benefits Survey

IC 123761 under ICR 198906-1220-001 · OMB 1220-0084.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1220-0084 can be found here:

Documents and Forms

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Information Collection (IC) Details

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IC Title:	EMPLOYEE BENEFITS SURVEY	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Migrated

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	BLS 3111				No	No

Line of Business:

Subfunction:

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 3,300	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	3,300	2,550	750
Annual IC Time Burden (Hours)	4,225	1,600	2,625
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

Title	Document	Date Uploaded

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