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Agenda
Reg Review
ICR
View Information Collection (IC)
View Information Collection (IC)
IC Title:
Labor Force Module of Persons with Disabilities Round 2
Agency IC Tracking Number:
16BEU
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-WORD
Labor Force - Attach 3 Telephone Screener rev.docx
Yes
Yes
Paper Only
Other-WORD
Labor Force - Attach 5 Resp Data Collect Sheet.docx
Yes
Yes
Fillable Fileable
Other-WORD
Labor Force - Attach 4 Informed Consent.docx
Yes
Yes
Paper Only
Form and Instruction
1
Questionnaire
Labor Force - Attach 1 Qnne 0826 2016 (1) V2.docx
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Public Health Monitoring
Privacy Act System of Records
Title:
Health and Demographic Surveys Conducted in Probability Samples of the US Population
FR Citation:
49 FR 37693
Number of Respondents:
68
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
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
68
0
68
0
0
0
Annual IC Time Burden (Hours)
24
0
24
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
Request for Approval
Labor Force -10day letter 092116.docx
09/21/2016
Att 2a _ Labor Force Module
Labor Force - Attach 2a-c Ads&Flyers.docx
09/21/2016
Att 6_Thank You Letter
Labor Force - Attach 6 Thank You Letter.docx
09/21/2016
Att 7_Special Consent for Expanded Use
Labor Force - Attach 7 Special Consent.docx
09/21/2016
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.