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Rehablitation Plan and Award
Rehabilitation Plan and Award
OMB: 1215-0067
IC ID: 13717
OMB.report
DOL/ESA
OMB 1215-0067
ICR 200712-1215-003
IC 13717
( )
Documents and Forms
Document Name
Document Type
Form OWCP-16
Rehablitation Plan and Award
Form
OWCP-16 Rehabilitation Plan and Award
OWCP-16 (current).pdf
www.dol.gov/esa/regs/compliance/owcp/OWCP-16.pdf
Form
OWCP-16 Rehabilitation Plan and Award
Draft OWCP-16 with proposed changes December 2007.doc
Form
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Rehablitation Plan and Award
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Modified
Obligation to Respond:
Required to Obtain or Retain Benefits
CFR Citation:
20 CFR 702.507
20 CFR 10.519
20 CFR 702.506
20 CFR 10.518
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form
OWCP-16
Rehabilitation Plan and Award
OWCP-16 (current).pdf
http://www.dol.gov/esa/regs/compliance/owcp/OWCP-16.pdf
Yes
No
Fillable Printable
Form
OWCP-16
Rehabilitation Plan and Award
Draft OWCP-16 with proposed changes December 2007.doc
Yes
No
Fillable Printable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Workforce Management
Subfunction:
Training and Employment
Privacy Act System of Records
Title:
DOL/GOVT-1(FECA);DOL/ESA-15(LHWCA)
FR Citation:
67 FR 16815
Number of Respondents:
7,000
Number of Respondents for Small Entity:
0
Affected Public:
Private Sector
Private Sector:
Businesses or other for-profits
Percentage of Respondents Reporting Electronically:
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
7,000
0
0
0
0
7,000
Annual IC Time Burden (Hours)
3,500
0
0
0
0
3,500
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
No associated records found
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.