Information Collection

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

IC 38478 under ICR 200205-1215-003 · 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⚠️ Notice: This information collection may be referencing outdated material.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-3	No	No
Form	EE-15	No	No
Form	EE-4	No	No
Form	EE-20	No	No
Form	EE-1	No	No
Form	EE-915	No	No
Form	EE-7	No	No

Line of Business:

Subfunction:

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 254,661	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	269,946	-3,000	272,946
Annual IC Time Burden (Hours)	125,943	-750	126,693
Annual IC Cost Burden (Dollars)	62,000	0	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.