Information Collection

Rehablitation Plan and Award

IC 13717 under ICR 201003-1240-045 · OMB 1240-0045.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1240-0045 can be found here:

Documents and Forms

Document Name Document Type
Form OWCP-16 Rehablitation Plan and Award Form
OWCP-16 Rehabilitation Plan and Award OWCP-16 (current).pdf www.dol.gov/esa/regs/compliance/owcp/OWCP-16.pdf Form
OWCP-16 Rehabilitation Plan and Award Draft OWCP-16 with proposed changes December 2007.doc Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Rehablitation Plan and Award	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 20 CFR 10.519 20 CFR 702.507 20 CFR 702.506 20 CFR 10.518

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	OWCP-16	Rehabilitation Plan and Award	OWCP-16 (current).pdf	http://www.dol.gov/esa/regs/compliance/owcp/OWCP-16.pdf	Yes	No	Fillable Printable
Form	OWCP-16	Rehabilitation Plan and Award	Draft OWCP-16 with proposed changes December 2007.doc		Yes	No	Fillable Printable

Line of Business: Workforce Management

Subfunction: Training and Employment

Privacy Act System of Records
Title: DOL/GOVT-1(FECA);DOL/ESA-15(LHWCA)	FR Citation: 67 FR 16815

Number of Respondents: 7,000	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Previously Approved
Annual Number of Responses for this IC	7,000	7,000
Annual IC Time Burden (Hours)	3,500	3,500
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.