FECA Medical Report Forms, Claim for Compensation

FECA Medical Report Forms, Claim for Compensation

OMB: 1215-0103

IC ID: 13769

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

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FECA Medical Report Forms, Claim for Compensation
 
No Migrated
 
Mandatory
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form CA-1332 No No
Form CA-1305 No No
Form CA-1087 No No
Form CA-1331 No No
Form CA-1303 No No
Form CA-16 No No
Form CA-1090 No No
Form CA-17 No No
Form CA-7 No No
Form CA-20 No No


    

286,010 0
   
Private Sector Businesses or other for-profits
 
   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 286,010 0 56 -16,674 0 302,628
Annual IC Time Burden (Hours) 28,990 0 6 -1,782 0 30,766
Annual IC Cost Burden (Dollars) 106,000 0 0 -3,000 0 109,000

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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