View Information Collection (IC)

View Information Collection (IC)

IC Title:	Retaining Employment and Talent After Injury/Illness Network (RETAIN) Grants	Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-FOA			RETAIN FOA_2018-05-04_clean.docx	www.Grants.gov and https://www.doleta.gov/grants/find_grants.cfm	Yes	Yes	Fillable Fileable

Federal Enterprise Architecture Business Reference Module

Line of Business: Workforce Management

Subfunction: Worker Safety

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 10	Number of Respondents for Small Entity: 10

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

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	10	0	10	0	0	0
Annual IC Time Burden (Hours)	200	0	200	0	0	0
Annual IC Cost Burden (Dollars)	0	0	0	0	0	0

Documents for IC

Title	Document	Date Uploaded
RETAIN Grants Supplementary Justification	RETAIN Grants Supplementary Statement.docx	05/18/2018

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