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Federal forms, ICRs, and supporting documents

Information Collection

Operator Controversion, Operator Response, Operator Response to Schedule for Submission of Additional Evidence, and Operator Response to Notice of Claim

IC 13697 under ICR 200704-1215-002 · OMB 1215-0058.

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

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Operator Controversion, Operator Response, Operator Response to Schedule for Submission of Additional Evidence, and Operator Response to Notice of Claim
 
No Modified
 
Mandatory
 
20 CFR 725.408 20 CFR 725.412

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form CM-2970 Operator Response to Schedule for Submission of Additional Evidence CM-2970.pdf http://www.dol.gov/esa/regs/compliance/owcp/cm-2970.pdf Yes Yes Fillable Fileable Signable
Form CM-2970A Operator Response to Notice of Claim CM-2970a.pdf http://www.dol.gov/esa/regs/compliance/owcp/cm-2970a.pdf Yes Yes Fillable Fileable Signable

Income Security General Retirement and Disability

DOL/ESA-15  58 FR 49559

8,000 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 8,000 0 -200 0 0 8,200
Annual IC Time Burden (Hours) 2,333 0 -42 666 0 1,709
Annual IC Cost Burden (Dollars) 3,520 0 0 520 0 3,000

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            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.