RETAIN Staff Activity Logs

Retaining Employment and Talent After Injury/Illness Network (RETAIN) demonstration

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0960-0821 can be found here:

Documents and Forms

Document Name Document Type
APPENDIX D - STAFF ACTIVITY LOGS.pdf Other-RETAIN Staff Activity Logs
APPENDIX D - STAFF ACTIVITY LOGS.pdf Other-RETAIN Staff Activity Logs

Information Collection (IC) Details

IC Title:	RETAIN Staff Activity Logs	Agency IC Tracking Number:

Is this a Common Form? No		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-RETAIN Staff Activity Logs			APPENDIX D - STAFF ACTIVITY LOGS.pdf		No		Paper Only

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 52	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Change Due to Adjustment in Agency Estimate
Annual Number of Responses for this IC	52	52
Annual IC Time Burden (Hours)	61	61
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

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