Agreement and Undertaking

Agreement and Undertaking

OMB: 1240-0039

IC ID: 13662

Documents and Forms
Information Collection (IC) Details

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Agreement and Undertaking
 
No Modified
 
Required to Obtain or Retain Benefits
 
20 CFR 726.110

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction OWCP-1 Agreement and Undertaking OWCP-1.pdf http://www.dol.gov/owcp/dfec/regs/compliance/OWCP-1.pdf Yes No Fillable Printable

Income Security General Retirement and Disability

 

20 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 20 0 0 0 0 20
Annual IC Time Burden (Hours) 5 0 0 0 0 5
Annual IC Cost Burden (Dollars) 10 0 0 1 0 9

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

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