Information Collection

Rehablitation Plan and Award

IC 13717 under ICR 202311-1240-001 · OMB 1240-0045.

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 updated 11.09.23.pdf www.dol.gov/owcp/dfec/regs/compliance/OWCP-16.pdf Form and Instruction
OWCP-16 Rehabilitation Plan and Award owcp-16 updated 11.09.23.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 702.506 20 CFR 702.507 20 CFR 10.519 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 and Instruction	OWCP-16	Rehabilitation Plan and Award	owcp-16 updated 11.09.23.pdf	http://www.dol.gov/owcp/dfec/regs/compliance/OWCP-16.pdf	Yes	Yes	Fillable Fileable Signable

Line of Business: Workforce Management

Subfunction: Training and Employment

Privacy Act System of Records
Title: DOL/GOVT-1(FECA);DOL/OWCP-3 (LHWCA)	FR Citation: 81 FR 47418

Number of Respondents: 3,413	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	3,413	237	3,176
Annual IC Time Burden (Hours)	1,707	119	1,588
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.