Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
ER recordkeeping (private) EPSLA Unchanged 950000 19792 0
Concurrent Leave Notice (Federal) Removed 0 0 0
Concurrent Leave Notice (State/local/tribal) Removed 0 0 0
Concurrent leave notice (private) Removed 0 0 0
EFMLEA Employee Notice (Federal) Removed 0 0 0
EFMLEA Employee Notice (State/local/tribal) Removed 0 0 0
EFMLEA Employee Notice (private) Removed 0 0 0
EFMLEA Employer Record (Federal) Modified 270 6 0
EFMLEA Employer Record (State/local/tribal) Modified 134484 2802 0
EFMLEA Employer Record (private) Modified 2560326 53341 0
ER notice to EE failure to meet notice req (State/local/tribal) Removed 0 0 0
ER notice to EE of failure to meet notice req (federal) Removed 0 0 0
ER notice to EE of failure to meet notice req (private) Removed 0 0 0
ER recordkeeping (Federal) EPSlA Unchanged 2000 42 0
ER recordkeeping (public State/local/tribal) EPSLA Unchanged 48000 1000 0
Health Benefits Notice (private) Removed 0 0 0
Health Care Provider Certification (Federal) Removed 0 0 0
Health Care Provider Certification (State/local/tribal) Removed 0 0 0
Health Care Provider Certification (private) Removed 0 0 0
Paid Sick Leave Notice of Need for Leave (Federal) Removed 0 0 0
Paid Sick Leave Notice of Need for Leave (private) Removed 0 0 0
Paid Sick Leave Notice of Need for Leave (state, local, tribal) Removed 0 0 0
Small Employer Exemption (State/local/tribal) Modified 28776 599 0
Small Employer Exemption Record (Private) Modified 546755 11391 0
Tax Credit Records (Federal) Modified 370 8 0
Tax Credit Records (State/local/tribal) Modified 184384 3841 0
Tax Credit Records (private) Modified 3510326 73132 0
Total burden requested under this ICR: 7965691 165954 0  
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