Letter To Non-railroad Employers (employment And Earnings Of A Claimant)

LETTER TO NON-RAILROAD EMPLOYERS (EMPLOYMENT AND EARNINGS OF A CLAIMANT)

OMB: 3220-0049

IC ID: 157436

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LETTER TO NON-RAILROAD EMPLOYERS (EMPLOYMENT AND EARNINGS OF A CLAIMANT)
 
No Migrated
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form ID-5I No No


    

10,000 0
   
Private Sector Businesses or other for-profits
 
   0 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 10,000 0 0 10,000 0 0
Annual IC Time Burden (Hours) 833 0 0 833 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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