Information Collection

FECA Medical Report Forms

IC 13766 under ICR 199608-1215-001 · OMB 1215-0103.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1215-0103 can be found here:

Documents and Forms

Document Name Document Type

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Information Collection (IC) Details

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IC Title:	FECA Medical Report Forms	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Migrated

Obligation to Respond: Mandatory

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Available Electronically?	Can Be Submitted Electronically?
Form	CA-1314	No	No
Form	CA-7-8	No	No
Form	CA-17B	No	No
Form	CA-1035-1306	No	No
Form	CA-1090	No	No
Form	CA-20-20A	No	No
Form	CA-16B	No	No
Form	CA-1316	No	No
Form	CA-1030	No	No
Form	CA-1331-1332	No	No

Line of Business:

Subfunction:

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 441,855	Number of Respondents for Small Entity: 0

Affected Public: Federal Government

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	441,855	-1,206	-44,289	487,350
Annual IC Time Burden (Hours)	43,412	-3,500	-128,486	175,398
Annual IC Cost Burden (Dollars)	154,000	154,000	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.