OMB control number

Request for Employment Information

OMB 1240-0047 · DOL/OWCP.

OMB 1240-0047

This information collection is used to collect information about a claimant's employment. It is necessary to determine continued eligibility for compensation payments under the Federal Employees' Compensation Act.

The latest form for Request for Employment Information expires 2028-07-31 and can be found here.

Latest Forms, Documents, and Supporting Material

Document Name
Form CA-1027 Request for Employer Information Form and Instruction
Form CA-1027 Request for Employment Information Form and Instruction
PC_202504-1240-001_072425_111054_1.pdf (document unavailable) Public Comments
Supporting Statement 1240-0047 (CA-1027) OCIO1.docx Supporting Statement A
Comment received for 1240-0047.pdf (document unavailable) Public Comments
5 U.S.C. 8106.docx Supplementary Document
OPM RUS Pay Scale 2025.pdf Supplementary Document
BLS Current Salary Dec 2024.pdf Supplementary Document
Request for Employment Information Form and Instruction
Request for Employment Information Form and Instruction

All Historical Document Collections

202504-1240-001	Extension without change of a currently approved collection	2025-06-24
202204-1240-001 Approved without change	Revision of a currently approved collection	2022-06-29
201902-1240-002 Approved without change	Revision of a currently approved collection	2019-05-31
201507-1240-003 Approved without change	Revision of a currently approved collection	2016-01-29
201209-1240-004 Approved without change	Revision of a currently approved collection	2012-12-11
201003-1240-047 Approved without change	Extension without change of a currently approved collection	2010-03-12