Information Collection

Rehabilitation Action Report

IC 13901 under ICR 200802-1215-001 · OMB 1215-0182.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form OWCP-44 Rehabilitation Action Report	Form
OWCP-44 Rehabilitation Action Report 1215-0182 (OWCP-44).pdf www.dol.gov/esa/regs/compliance/owcp/OWCP-44.pdf	Form

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	OWCP-44	Rehabilitation Action Report	1215-0182 (OWCP-44).pdf	http://www.dol.gov/esa/regs/compliance/owcp/OWCP-44.pdf	Yes	Yes	Fillable Fileable Signable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title: DOL/GOVT-1 (FECA); DOL/ESA-15 (LHWCA)

FR Citation: 67 FR 16826

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 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	7,000	7,000
Annual IC Time Burden (Hours)	1,169	1,169
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
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.