Information Collection

FECA Claimat Survey Package

IC 193965 under ICR 200909-1225-001 · OMB 1225-0059.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1225-0059 can be found here:

Documents and Forms

Document Name Document Type
Injured Worker Survey_v1 3.pdf Other-Survey
VPAT_SurveyMonkey.pdf Other-Survey
Claimant Survey Letter.doc Other-Survey Letter
Supporting Statement (1225-0059).doc Supporting Statement IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	FECA Claimat Survey Package	Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Survey	Injured Worker Survey_v1 3.pdf	Yes	Yes	Fillable Fileable
Other-Survey	VPAT_SurveyMonkey.pdf	Yes	Yes	Fillable Fileable
Other-Survey Letter	Claimant Survey Letter.doc	Yes	No	Paper Only

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 1,620	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	1,620	1,620
Annual IC Time Burden (Hours)	405	405
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Supporting Statement	Supporting Statement (1225-0059).doc	08/03/2010

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.