Information Collection

Claims Under the Radiation Exposure Compensation Act (RECA)

IC 11747 under ICR 201411-1105-001 · OMB 1105-0052.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1105-0052 can be found here:

Documents and Forms

Document Name Document Type
Form OMB Number 1105-00 Claims Under the Radiation Exposure Compensation Act (RECA) Form and Instruction
OMB Number 1105-00 RECA Downwinder RECA Downwinder_revised_091311.pdf www.usdoj.gov/civil/torts/const/reca/claimform.htm Form and Instruction
OMB Number 1105-00 RECA Onsite Participant RECA Onsite Participant_revised_091311.pdf www.usdoj.gov/civil/torts/const/reca/claimform.htm Form and Instruction
OMB Number 1105-00 RECA Uranium Mill RECA Uranium Mill_revised_091311.pdf www.usdoj.gov/civil/torts/const/reca/claimform.htm Form and Instruction
OMB Number 1105-00 RECA Uranium Mine RECA Uranium Mine_revised_091311.pdf www.usdoj.gov/civil/torts/const/reca/claimform.htm Form and Instruction
OMB Number 1105-00 RECA Uranium Ore RECA Uranium Ore_revised_091311.pdf www.usdoj.gov/civil/torts/const/reca/claimform.htm Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Claims Under the Radiation Exposure Compensation Act (RECA)	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Unchanged

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 and Instruction	OMB Number 1105-0052	RECA Downwinder	RECA Downwinder_revised_091311.pdf	http://www.usdoj.gov/civil/torts/const/reca/claimform.htm	Yes	No	Printable Only
Form and Instruction	OMB Number 1105-0052	RECA Onsite Participant	RECA Onsite Participant_revised_091311.pdf	http://www.usdoj.gov/civil/torts/const/reca/claimform.htm	Yes	No	Printable Only
Form and Instruction	OMB Number 1105-0052	RECA Uranium Mill	RECA Uranium Mill_revised_091311.pdf	http://www.usdoj.gov/civil/torts/const/reca/claimform.htm	Yes	No	Printable Only
Form and Instruction	OMB Number 1105-0052	RECA Uranium Mine	RECA Uranium Mine_revised_091311.pdf	http://www.usdoj.gov/civil/torts/const/reca/claimform.htm	Yes	No	Printable Only
Form and Instruction	OMB Number 1105-0052	RECA Uranium Ore	RECA Uranium Ore_revised_091311.pdf	http://www.usdoj.gov/civil/torts/const/reca/claimform.htm	Yes	No	Printable Only

Line of Business: Litigation and Judicial Activities

Subfunction: Resolution Facilitation

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 2,000	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Previously Approved
Annual Number of Responses for this IC	2,000	2,000
Annual IC Time Burden (Hours)	5,000	5,000
Annual IC Cost Burden (Dollars)	50,000	50,000

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.