Information Collection

Rehablitation Plan and Award

IC 13717 under ICR 201011-1240-005 · 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⚠️ Notice: This information collection may be referencing outdated material.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 and Instruction
OWCP-16 Rehabilitation Plan and Award OWCP-16(2011Final).pdf www.dol.gov/owcp/dfec/regs/compliance/OWCP-16.pdf Form and Instruction

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 702.507 20 CFR 702.506 20 CFR 10.518 20 CFR 10.519

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	OWCP-16	Rehabilitation Plan and Award	OWCP-16(2011Final).pdf	http://www.dol.gov/owcp/dfec/regs/compliance/OWCP-16.pdf	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: 5,500	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	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	5,500	-1,500	7,000
Annual IC Time Burden (Hours)	2,750	-750	3,500
Annual IC Cost Burden (Dollars)	0	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.