Note to Reviwer

NOTE TO REVIEWER

OMB No. 1215-0176

In its prior March 26, 2007 “Notice of Office of Management and Budget Action” on this Information Collection Request, OMB indicated that the title for this IC was “Uniform Billing Form (UB-92)” and that it included two forms “OWCP/UB-92” and “OWCP/UB-04.” This was the result of a lack of explanation on the 83-C that was submitted in 1215-0176 on January 10, 2007. However, and as noted in the current supporting statement, neither the obsolete UB-92 nor the current UB-04 are government forms. All that 1215-0176 requests is approval for the collection of a portion of the information that can be entered on the UB-04. It is the instructions that OWCP has attached to the UB-04 that are the focus of 1215-0176.