National Worker Survey

Formative Data Collections for DOL Research

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1290-0043 can be found here:

Documents and Forms

Document Name Document Type
Appendix A WesInfo Advertisement.docx Instruction
Appendix A WesInfo Advertisement.docx Instruction
Appendix B General Advertisement.docx Instruction
Appendix B General Advertisement.docx Instruction
Appendix C E-mail to Workers’ Rights Organizations for Recruitment for Formative Research.docx Instruction
Appendix C E-mail to Workers’ Rights Organizations for Recruitment for Formative Research.docx Instruction
Appendix D Confirmation Email for In-person Participants.docx Instruction
Appendix D Confirmation Email for In-person Participants.docx Instruction
Appendix E Respondent Screener_8_16_23.docx Other-Respondent Screener
Appendix E Respondent Screener_8_16_23.docx Other-Respondent Screener
Appendix F Formative Research Interview Guide_8_16_23.docx Other-Interview Guide
Appendix F Formative Research Interview Guide_8_16_23.docx Other-Interview Guide
Appendix G Survey Invitation Letter.docx Other-Invitation Letter
Appendix G Survey Invitation Letter.docx Other-Invitation Letter
1290- 0043 SSA Formative Generic_WkrSurvey_9_07_23.docx Supporting Statement Part A IC Document
1290- 0043 SSA Formative Generic_WkrSurvey_9_07_23.docx Supporting Statement Part A IC Document

Information Collection (IC) Details

IC Title:	National Worker Survey	Agency IC Tracking Number:

IC Status: Unchanged

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Instruction	Appendix A WesInfo Advertisement.docx	Yes	Yes	Fillable Fileable
Instruction	Appendix B General Advertisement.docx	Yes	Yes	Fillable Fileable
Instruction	Appendix C E-mail to Workers’ Rights Organizations for Recruitment for Formative Research.docx	Yes	Yes	Fillable Fileable
Instruction	Appendix D Confirmation Email for In-person Participants.docx	Yes	Yes	Fillable Fileable
Other-Respondent Screener	Appendix E Respondent Screener_8_16_23.docx	Yes	Yes	Fillable Fileable
Other-Interview Guide	Appendix F Formative Research Interview Guide_8_16_23.docx	Yes	Yes	Fillable Fileable
Other-Invitation Letter	Appendix G Survey Invitation Letter.docx	Yes	Yes	Fillable Fileable

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: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Requested	Previously Approved
Annual Number of Responses for this IC	10	10
Annual IC Time Burden (Hours)	11	11
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Supporting Statement Part A	1290- 0043 SSA Formative Generic_WkrSurvey_9_07_23.docx	09/08/2023

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