Claim for Reimbursement-Assisted Reemployment

Statement of Recovery Forms

OMB: 1215-0200

IC ID: 13938

Information Collection (IC) Details

View Information Collection (IC)

Claim for Reimbursement-Assisted Reemployment
 
No Modified
 
Required to Obtain or Retain Benefits
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction ca-1108 Statement of Recovery revised 1108 5-04-09[1][1].doc http://www/dol.gov/esa/owcp/regs/compliance/ca-1108.pdf Yes No Fillable Printable

Workforce Management Labor Rights Management

DOL/GOVT-1  67 FR 16826

25 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 25 0 -2,675 -500 0 3,200
Annual IC Time Burden (Hours) 13 0 -1,337 -170 0 1,520
Annual IC Cost Burden (Dollars) 11 0 -1,204 215 0 1,000

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