Manager Consent and Interview

Assessment of Ill Worker Policies Study

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-1227 can be found here:

Documents and Forms

Document Name Document Type
Manager Consent and Interview Form and Instruction
Manager consent and interview P_Att 3 Manager InfrmdCnsnt Intrvw 201211.docx Form and Instruction
Manager consent and interview P_Att 3 Manager InfrmdCnsnt Intrvw 201211.docx Form and Instruction
Att 6 Manager Interview Marking Guide.docx Interview Marking Guide IC Document
Att 6 Manager Interview Marking Guide.docx Interview Marking Guide IC Document

Information Collection (IC) Details

IC Title:	Manager Consent and Interview	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

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
Form and Instruction	none	Manager consent and interview	P_Att 3 Manager InfrmdCnsnt Intrvw 201211.docx		Yes	No	Paper Only

Line of Business: Health

Subfunction: Illness Prevention

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 53	Number of Respondents for Small Entity: 27

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

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	106	52	54
Annual IC Time Burden (Hours)	35	17	18
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

Title	Document	Date Uploaded
Interview Marking Guide	Att 6 Manager Interview Marking Guide.docx	11/08/2017

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