Request for State or Federal Workers' Compensation Information

Request for State or Federal Workers' Compensation Information

OMB: 1215-0060

IC ID: 13702

Documents and Forms
Document Name
Document Type
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Information Collection (IC) Details

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Request for State or Federal Workers' Compensation Information
 
No Migrated
 
Mandatory
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form CM-905 No No


    

3,522 0
   
Federal Government
 
   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 3,522 0 0 -464 0 3,986
Annual IC Time Burden (Hours) 881 0 0 -115 0 996
Annual IC Cost Burden (Dollars) 12,000 0 11,000 0 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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