Information Collection

Energy Employees Occupational Illness Compensation Program Act Forms (Various)

IC 13934 under ICR 200506-1215-001 · 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⚠️ Notice: This information collection may be referencing outdated material.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: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Available Electronically?	Can Be Submitted Electronically?
Form	EE-7	No	No
Form	EE-20	No	No
Form	EE-1	No	No
Form	EE-9	No	No
Form	EE-10	No	No
Form	EE-2	No	No
Form	EE-3	No	No
Form	EE-8	No	No
Form	EE-4	No	No

Line of Business:

Subfunction:

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 90,863	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	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	92,763	40,480	2,264	50,019
Annual IC Time Burden (Hours)	41,378	17,883	1,000	22,495
Annual IC Cost Burden (Dollars)	22,000	9,000	0	13,000

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.