Information Collection

Worker Classification Survey-Employer Interview

IC 209148 under ICR 201303-1235-002 · OMB 1235-0028.

Documents and Forms

Document Name Document Type
Worker Classification Survey-OMB Attachment E 09-13-13.docx Other-Survey
Worker Classification Survey-OMB Attachment B Privacy Statement 09-13-13.docx Worker Classification Survey OMB Attachment B-Privacy Statement IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Worker Classification Survey-Employer Interview	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-Survey			Worker Classification Survey-OMB Attachment E 09-13-13.docx		Yes	No	Printable Only

Line of Business: Workforce Management

Subfunction: Labor Rights Management

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 100	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	120	120
Annual IC Time Burden (Hours)	45	45
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Worker Classification Survey OMB Attachment B-Privacy Statement	Worker Classification Survey-OMB Attachment B Privacy Statement 09-13-13.docx	11/01/2013

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