Enrollee Survey Round 1 (nonrespondents)

Retaining Employment and Talent After Injury/Illness Network (RETAIN) demonstration

OMB: 0960-0821

IC ID: 266927

Documents and Forms
Document Name
Document Type
Other-ENROLLEE SURVEY INSTRUMENTS (R
Other-ENROLLEE SURVEY INSTRUMENTS (R
Other-ENROLLEE SURVEY INSTRUMENTS (R
Other-ENROLLEE SURVEY INSTRUMENTS (R
Information Collection (IC) Details

View Information Collection (IC)

Enrollee Survey Round 1 (nonrespondents)
 
No New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-ENROLLEE SURVEY INSTRUMENTS (Round 1). APPENDIX B - ENROLLEE SURVEY INSTRUMENTS (Round 1).pdf Yes Yes Fillable Fileable
Other-ENROLLEE SURVEY INSTRUMENTS (Round 1) APPENDIX C - ENROLLEE SURVEY MAILINGS (Round 1).pdf No   Paper Only

Income Security General Retirement and Disability

 

468 0
   
Individuals or Households
 
   100 %

  Approved 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 468 0 0 468 0 0
Annual IC Time Burden (Hours) 23 0 0 23 0 0
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.

© 2024 OMB.report | Privacy Policy