Information Collection Request
Notice of Issuance of Insurance Policy
ICR 202401-1240-011 · OMB 1240-0048 · Active
Forms and Documents
| Document | Type | Status | Availability |
|---|---|---|---|
 Form CM-921 Notice of Issuance of Insurance Policy |
Form | Modified | Available |
| Form CM-921 Notice of Issuance of Insurance Policy |
Form | Modified | Repair queued |
 SS 1240-0048 9.11.23_MN-MM.docx |
Supporting Statement A | Uploaded 2024-01-30 | Available |
| SS 1240-0048 9.11.23_MN-MM.docx |
Supporting Statement A | Uploaded 2024-01-30 | Repair queued |
| Justification CM-921.docx |
Justification for No Material/Nonsubstantive Change | Uploaded 2024-01-30 | Repair queued |
| Justification CM-921.docx |
Justification for No Material/Nonsubstantive Change | Uploaded 2024-01-30 | Repair queued |
 2023 30-Day FRN_1240-0048.pdf |
Supplementary Document | Uploaded 2023-10-04 | Available |
| 2023 30-Day FRN_1240-0048.pdf |
Supplementary Document | Uploaded 2023-10-04 | Repair queued |
| 2023 60-Day FRN_1240-0048.pdf |
Supplementary Document | Uploaded 2023-09-28 | Available |
| 2023 60-Day FRN_1240-0048.pdf |
Supplementary Document | Uploaded 2023-09-28 | Repair queued |
| System of Record Notice-DOL OWCP-2.pdf |
Supplementary Document | Uploaded 2019-10-29 | Available |
| System of Record Notice-DOL OWCP-2.pdf |
Supplementary Document | Uploaded 2019-10-29 | Missing upstream |
| 20_CFR_Part_V_Subpart_C_726.208-213.pdf |
Supplementary Document | Uploaded 2013-05-10 | Repair queued |
| 20_CFR_Part_V_Subpart_C_726.208-213.pdf |
Supplementary Document | Uploaded 2013-05-10 | Repair queued |
| 30 USC Section 933.pdf |
Supplementary Document | Uploaded 2013-05-10 | Available |
| 30 USC Section 933.pdf |
Supplementary Document | Uploaded 2013-05-10 | Repair queued |
| NCCI screen shot.docx |
Supplementary Document | Uploaded 2013-05-10 | Available |
| NCCI screen shot.docx |
Supplementary Document | Uploaded 2013-05-10 | Missing upstream |
IC Document Collections
| IC ID | Collection | Type | Status | Form |
|---|---|---|---|---|
| 13700 |  Notice of Issuance of Insurance Policy |
Form | Modified | |
| 13700 | Notice of Issuance of Insurance Policy |
Form | Modified |
ICR Details
| Status | Active |
|---|---|
| Agency/Subagency | DOL/OWCP |
| OMB Control No | 1240-0048 |
| Type of Information Collection | No material or nonsubstantive change to a currently approved collection |
| Previous ICR Reference No | 202306-1240-002 |
| Date Submitted to OIRA | 2024-01-31 |
| Requested Expiration Date | 1969-12-31 |