Information Collection

Owcp Representative Fee Request: Feca (ca-38), Black Lung (cm-972), And Longshore (20 Cfr 702.132) Programs

IC 122084 under ICR 198501-1215-002 · OMB 1215-0078.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1215-0078 can be found here:

Documents and Forms

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Information Collection (IC) Details

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IC Title:	OWCP REPRESENTATIVE FEE REQUEST: FECA (CA-38), BLACK LUNG (CM-972), AND LONGSHORE (20 CFR 702.132) PROGRAMS	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Migrated

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Available Electronically?	Can Be Submitted Electronically?
Form	CM-972	No	No
Form	(BL)	No	No
Form	CA-38 (FECA)	No	No

Line of Business:

Subfunction:

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 14,500	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Change Due to Adjustment in Agency Estimate
Annual Number of Responses for this IC	14,500	14,500
Annual IC Time Burden (Hours)	10,183	10,183
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.