Information Collection

Rehabilitation Action Report

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

Documents and Forms

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

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Rehabilitation Action Report	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:

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 %

	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

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.