Script for Reasonable Accommodation Submission

Information Collection Submission for MSPB Reasonable Accommodation Requests

Documents and Forms

Document Name Document Type
Script for Reasonable Accommodation Submission Form
Script for Reasonable Accommodation Request SCRIPT~1.PDF Form

Information Collection (IC) Details

IC Title:	Script for Reasonable Accommodation Submission	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
Form	N/A	Script for Reasonable Accommodation Request	SCRIPT~1.PDF		Yes	No	Paper Only

Line of Business: Workforce Management

Subfunction: Worker Safety

Privacy Act System of Records
Title: Reasonable Accommodation	FR Citation: 86 FR 73001

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

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Requested	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	50	50
Annual IC Time Burden (Hours)	50	50
Annual IC Cost Burden (Dollars)	1,895	1,895

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.