Information Collection Request
Claim for Consequential Illness Benefits Under the Energy Employees Occupational Illness Compensation Program Act
ICR 202405-1240-001 · OMB 1240-0063 · Received in OIRA
Forms and Documents
| Document | Type | Status | Availability |
|---|---|---|---|
 Form EE-1 Claim for Consequential Illness Benefits under the Employees Occupational Illness Compensation Program Act |
Form and Instruction | New | Repair queued |
 1240-0NEW_Supporting Statement_DEEOIC Consequential Illness Form (EE1-A)_FINAL.docx |
Supporting Statement A | Uploaded 2024-05-22 | Repair queued |
IC Document Collections
| IC ID | Collection | Type | Status | Form |
|---|---|---|---|---|
| 267380 |  Claim for Consequential Illness Benefits under the Employees Occupational Illness Compensation Program Act |
Form and Instruction | New |
ICR Details
| Status | Received in OIRA |
|---|---|
| Agency/Subagency | DOL/OWCP |
| OMB Control No | 1240-0063 |
| Type of Information Collection | New collection (Request for a new OMB Control Number) |
| Date Submitted to OIRA | 1969-12-31 |
| Requested Expiration Date | 1969-12-31 |