Information Collection

Energy Employees' Occupational Illness Compensation Program Act forms (various)

IC 13931 under ICR 200105-1215-003 · OMB 1215-0197.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1215-0197 can be found here:

Documents and Forms

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Information Collection (IC) Details

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IC Title:	Energy Employees' Occupational Illness Compensation Program Act forms (various)	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	EE-2	No	No
Form	EE-20	No	No
Form	EE-1	No	No
Form	EE-15	No	No
Form	EE-915	No	No
Form	EE-7	No	No
Form	EE-3	No	No
Form	EE-4	No	No

Line of Business:

Subfunction:

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 257,661	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	272,946	272,946
Annual IC Time Burden (Hours)	126,693	126,693
Annual IC Cost Burden (Dollars)	62,000	62,000

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.