View Information Collection (IC)

View Information Collection (IC)

View Information Collection (IC)

IC Title:	Employee Benefits Security Administration Health Benefits Education Outreach Survey	Agency IC Tracking Number:

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-Web-based survey			HBEC SURVEY(2014).pdf		No		Paper Only

Federal Enterprise Architecture Business Reference Module

Line of Business: Workforce Management

Subfunction: Labor Rights Management

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 50	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 0 %

	Requested	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	50	0	50	0	0	0
Annual IC Time Burden (Hours)	2	0	2	0	0	0
Annual IC Cost Burden (Dollars)	0	0	0	0	0	0

Documents for IC

Title	Document	Date Uploaded
Supplemental Justification Supporting Statement for Employee Benefits Security Administration Health Benefits Education Outreach Survey	HBEC Survey clearance form 2014.pdf	06/29/2014

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