Information Collection

Paid Sick Leave Record Designation

IC 219204 under ICR 201512-1235-002 · OMB 1235-0029.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1235-0029 can be found here:

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Information Collection (IC) Details

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IC Title:	Paid Sick Leave Record Designation	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 29 CFR 13.25

Information Collection Instruments:

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

Line of Business: Workforce Management

Subfunction: Labor Rights Management

Privacy Act System of Records
Title: Paid Sick Leave Record Designation	FR Citation: 81 FR 9592

Number of Respondents: 322,067	Number of Respondents for Small Entity: 29,524

Affected Public: Private Sector	Private Sector: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 90 %

	Requested	Program Change Due to New Statute
Annual Number of Responses for this IC	1,288,268	1,288,268
Annual IC Time Burden (Hours)	21,471	21,471
Annual IC Cost Burden (Dollars)	0	0

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