Employee Non-Response Follow-up Survey

Family and Medical Leave Act, Wave 4 Surveys

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1290-0015 can be found here:

Documents and Forms

Document Name Document Type
FMLA Wave 4 Surveys_OMB Attachment A.3_Employee NRFU_7.25.17.doc Other-Employee non-response survey

Information Collection (IC) Details

IC Title:	Employee Non-Response Follow-up Survey	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-Employee non-response survey			FMLA Wave 4 Surveys_OMB Attachment A.3_Employee NRFU_7.25.17.doc		No		Printable Only

Line of Business: Workforce Management

Subfunction: Labor Rights Management

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 167	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	167	167
Annual IC Time Burden (Hours)	28	28
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.