OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

Health Benefits Notice (private)

IC 240992 under ICR 202005-1235-003 · OMB 1235-0031.

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)

Health Benefits Notice (private)
 
No Unchanged
 
Required to Obtain or Retain Benefits
 
29 CFR 826.110

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

Workforce Management Labor Rights Management

 

170,337 50
   
Private Sector Businesses or other for-profits, Farms, Not-for-profit institutions
 
   70 %

  Requested Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 170,337 0 0 0 0 170,337
Annual IC Time Burden (Hours) 14,195 0 0 0 0 14,195
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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.