Information Collection

Uniform Billing Form

IC 38466 under ICR 200506-1215-012 · OMB 1215-0176.

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Documents and Forms

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Information Collection (IC) Details

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IC Title:	Uniform Billing Form	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.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	OWCP-92				Yes	Yes

Line of Business:

Subfunction:

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 57,806	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 15 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	231,224	508	230,716
Annual IC Time Burden (Hours)	26,984	59	26,925
Annual IC Cost Burden (Dollars)	0	0	0

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.