Payment of Compensation Without Award

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Documents and Forms

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Information Collection (IC) Details

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IC Title:	Payment of Compensation Without Award	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 20 CFR 702.234

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records
Title: DOL/GOVT-15	FR Citation: 67 FR 16870

Number of Respondents: 600	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 1 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	16,800	0	16,800
Annual IC Time Burden (Hours)	4,200	0	4,200
Annual IC Cost Burden (Dollars)	7,600	-1,136	8,736

Documents for IC

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