Information Collection

Work Activities Journal

IC 194610 under ICR 201009-0920-003 · OMB 0920-0874.

Documents and Forms

Document Name Document Type
Att D-1. WAJ_09BV.xls Other-WORD
Att D-2. WAJ Instructions_09BV_.doc Other-WORD

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Work Activities Journal	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

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
Other-WORD			Att D-1. WAJ_09BV.xls		Yes	Yes	Fillable Printable
Other-WORD			Att D-2. WAJ Instructions_09BV_.doc		Yes	Yes	Fillable Printable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 368	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
Annual Number of Responses for this IC	368	368
Annual IC Time Burden (Hours)	736	736
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

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.