OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

EEOICP Forms for Private Sector

IC 178683 under ICR 202002-1240-019 · OMB 1240-0002.

Documents and Forms
Document Name
Document Type
Form and Instruction
Form and Instruction
Form and Instruction
Information Collection (IC) Details

View Information Collection (IC)

EEOICP Forms for Private Sector
 
No Unchanged
 
Required to Obtain or Retain Benefits
 
20 CFR 30.222 20 CFR 30.215 20 CFR 30.103 20 CFR 30.415 through 30.417 20 CFR 30.207 20 CFR 30.905 20 CFR 30.232 (a) and (b) 20 CFR 30.907 20 CFR 30.106

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction EE-7 English Medial Requirements under rhe Energy Employees Occupational Illness Compensation Program Act EE-7.docx No   Paper Only
Form and Instruction EE-7 Spanish Requisitos medicos segun la Ley del Programa de Indemnizacion por Enfermedades Ocupacionales para Empleados del Sector de la Energia EE-7-Spa.docx No   Paper Only

Income Security General Retirement and Disability

DOL/OWCP-11  81 FR 25868

5,489 0
   
Private Sector Businesses or other for-profits
 
   0 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 5,489 0 0 0 0 5,489
Annual IC Time Burden (Hours) 1,372 0 0 0 0 1,372
Annual IC Cost Burden (Dollars) 3,019 0 0 0 0 3,019

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