Information Collection Request
Claim for Reimbursement of Benefit Payments and Claims Expense Under the War Hazards Compensation Act
ICR 202302-1240-004 · OMB 1240-0006 · Active
⚠️ Notice: This information collection may be outdated. More recent filings for OMB 1240-0006 can be found here:
Forms and Documents
| Document | Type | Status | Availability |
|---|---|---|---|
 Form CA-278 Claim for Reimbursement of Benefit Payments and Claims Expense Under the War Hazards Compensation Act |
Form and Instruction | Modified | Repair queued |
| Form CA-278 Claim for Reimbursement of Benefit Payments and Claims Expense Under the War Hazards Compensation Act |
Form and Instruction | Modified | Repair queued |
 Justification for Non material change. CA-278 2.21.2023.docx |
Supplementary Document | Uploaded 2023-02-22 | Available |
| Justification for Non material change. CA-278 2.21.2023.docx |
Supplementary Document | Uploaded 2023-02-22 | Repair queued |
| Justification for Non material change. CA-278 1.30.2023 (006).docx |
Supplementary Document | Uploaded 2023-02-01 | Available |
| Justification for Non material change. CA-278 1.30.2023 (006).docx |
Supplementary Document | Uploaded 2023-02-01 | Repair queued |
| Justification for Non material change. CA-278.docx |
Justification for No Material/Nonsubstantive Change | Uploaded 2022-08-02 | Available |
| Justification for Non material change. CA-278.docx |
Justification for No Material/Nonsubstantive Change | Uploaded 2022-08-02 | Repair queued |
 81 Fed. Reg 47418 (July 21, 2016).pdf |
Supplementary Document | Uploaded 2020-01-08 | Available |
| 81 Fed. Reg 47418 (July 21, 2016).pdf |
Supplementary Document | Uploaded 2020-01-08 | Missing upstream |
| Supporting Statement 1240-0006 final.docx |
Supporting Statement A | Uploaded 2022-08-02 | Available |
| Supporting Statement 1240-0006 final.docx |
Supporting Statement A | Uploaded 2022-08-02 | Repair queued |
| Occupational Employment Statistics 2018.docx |
Supplementary Document | Uploaded 2019-11-27 | Available |
| Occupational Employment Statistics 2018.docx |
Supplementary Document | Uploaded 2019-11-27 | Repair queued |
| 5 usc 8147 2019.docx |
Supplementary Document | Uploaded 2019-11-27 | Available |
| 5 usc 8147 2019.docx |
Supplementary Document | Uploaded 2019-11-27 | Repair queued |
| Salary Table Cleveland 2019.pdf |
Supplementary Document | Uploaded 2019-11-27 | Available |
| Salary Table Cleveland 2019.pdf |
Supplementary Document | Uploaded 2019-11-27 | Repair queued |
| CFR-2000-title20-vol1-sec61-104 for ca-278 mjs 2019.pdf |
Supplementary Document | Uploaded 2019-11-27 | Repair queued |
| CFR-2000-title20-vol1-sec61-104 for ca-278 mjs 2019.pdf |
Supplementary Document | Uploaded 2019-11-27 | Repair queued |
| CFR-2016-title20-vol1-sec61-101 for ca-278 mjs 2019.pdf |
Supplementary Document | Uploaded 2019-11-27 | Available |
| CFR-2016-title20-vol1-sec61-101 for ca-278 mjs 2019.pdf |
Supplementary Document | Uploaded 2019-11-27 | Repair queued |
IC Document Collections
| IC ID | Collection | Type | Status | Form |
|---|---|---|---|---|
| 13940 |  Claim for Reimbursement of Benefit Payments and Claims Expense Under the War Hazards Compensation Act |
Form and Instruction | Modified | |
| 13940 | Claim for Reimbursement of Benefit Payments and Claims Expense Under the War Hazards Compensation Act |
Form and Instruction | Modified |
ICR Details
| Status | Active |
|---|---|
| Agency/Subagency | DOL/OWCP |
| OMB Control No | 1240-0006 |
| Type of Information Collection | No material or nonsubstantive change to a currently approved collection |
| Previous ICR Reference No | 202301-1240-008 |
| Date Submitted to OIRA | 2023-02-22 |
| Requested Expiration Date | 1969-12-31 |