Claim for Compensation by Dependents Information Reports

Claim for Compensation by Dependents Information Reports

OMB: 1215-0155

IC ID: 13840

Documents and Forms
Document Name
Document Type
no available documents/forms check other ICs listed under this ICR
Information Collection (IC) Details

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Claim for Compensation by Dependents Information Reports
 
No Migrated
 
Required to Obtain or Retain Benefits
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form CA-1074 No No
Form CA-1093 No No
Form CA-5B No No
Form CA-1031 No No
Form CA-1617 No No
Form CA-1615 No No
Form CA-1618 No No
Form CA-1085 No No
Form CA-5 No No


    

1,895 0
   
Individuals or Households
 
   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 1,895 0 0 -1,720 0 3,615
Annual IC Time Burden (Hours) 1,210 0 0 -625 0 1,835
Annual IC Cost Burden (Dollars) 0 0 0 -1,000 0 1,000

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

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