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Federal forms, ICRs, and supporting documents

Information Collection Request

JWOD Employee Survey Interview Questionnaire, JWOD Employee Survey Mail Questionnaire, JWOD Benefit-Cost Analysis Employee Information Form

ICR 199711-3037-001 · OMB 3037-0009 · Historical Active

Forms and Documents
DocumentTypeStatusAvailability
No forms / supporting documents in this ICR. Check IC Document Collections.
IC Document Collections
IC IDCollectionTypeStatusForm
28998 JWOD Employee Survey Interview Questionnaire, JWOD Employee Survey Mail Questionnaire, JWOD Benefit-Cost Analysis Employee Information Form Migrated
ICR Details
3037-0009 199711-3037-001
Historical Active 199604-3037-001
CPBSD
JWOD Employee Survey Interview Questionnaire, JWOD Employee Survey Mail Questionnaire, JWOD Benefit-Cost Analysis Employee Information Form
Reinstatement with change of a previously approved collection   No
Regular
Approved without change 01/20/1998
Retrieve Notice of Action (NOA) 11/24/1997
Approved as amended by the Committee for Purchase from the Blind and Other Severely Handicapped's memos of 1/16/98 and 1/20/98. In addition, because the Committee has demonstrated that unique circumstances surrounding this survey render alternative methods for maximizing response rates insufficient, the Committee can offer monetary incentives to reimburse respondent for out of pocket expenses incurred in completing this survey as long as the monetary incentive does not exceed $10 in value for any one respondent. (Note: The purpose of the monetary incentive should not be to reimburse respondents for time spent completing the survey.)
  Inventory as of this Action Requested Previously Approved
06/30/1999 06/30/1999
1 0 0
441 0 0
0 0 0
Follow-up survey of JWOD employees to measure the effects of the Javits-Wagner-O'Day Program on the JWOD employees. This measure is to be one aspect of a comprehensive benefit/cost analysis of the JWOD Program. The analysis is to be used to identify areas where improvements are desirable and to collect in-depth descriptive data.
None
None
No
  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 1 0 0 1 0 0
Annual Time Burden (Hours) 441 0 0 441 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
No
$0
Yes Part B of Supporting Statement
No
Uncollected
Uncollected
Uncollected
Uncollected
  No
On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
 
 
 
 
 
 
 
    (i) Why the information is being collected;
    (ii) Use of information;
    (iii) Burden estimate;
    (iv) Nature of response (voluntary, required for a benefit, or mandatory);
    (v) Nature and extent of confidentiality; and
    (vi) Need to display currently valid OMB control number;
 
 
 
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
11/24/1997