Information Collection

Record of Cash-out

IC 219205 under ICR 201607-1235-001 · OMB 1235-0029.

⚠️ Notice: This information collection may be referencing outdated material.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

Documents and Forms

Document Name Document Type

No indexed documents/forms are available for this IC yet. A refresh has been queued.

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Record of Cash-out	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 29 CFR 13.25(15)

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: Record of Cash-out	FR Citation: 81 FR 9592

Number of Respondents: 454,067	Number of Respondents for Small Entity: 29,524

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

Percentage of Respondents Reporting Electronically: 90 %

	Approved	Program Change Due to New Statute
Annual Number of Responses for this IC	454,067	454,067
Annual IC Time Burden (Hours)	37,839	37,839
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.