View Information Collection (IC)

View Information Collection (IC)

Notice to Employee of Pending Cancellation of Health Benefits (Private Sector)
No Modified
29 CFR 825.212(a)

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability

Workforce Management Labor Rights Management


105,585 97,062
Private Sector Businesses or other for-profits, Farms, Not-for-profit institutions
   0 %

  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 105,585 2,138 0 103,447 0 0
Annual IC Time Burden (Hours) 8,799 1,777 0 7,022 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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