Information Collection

Overpayment Recovery Questionnaire

IC 38463 under ICR 201507-1240-002 · OMB 1240-0051.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1240-0051 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form OWCP-20 Overpayment Recovery Questionnaire	Form and Instruction
OWCP-20 Overpayment Recovery Questionnaire owcp-20.pdf www.dol.gov/esa/owcp/dfec/regs/compliance/OWCP-20.pdf	Form and Instruction
DOL Privacy Act systems ESA-6.pdf DOL/ESA-6	IC Document
DOL-ESA-30.pdf DOL/ESA-30	IC Document
DOL ESA-49.pdf DOL/ESA-49	IC Document
Supporting regulations EEOICPA.pdf supporting regulations EEOICPA	IC Document
7385j-2.pdf 7385j-2	IC Document
30 USC 923 (b).pdf 30 USC 923b	IC Document
8129 Recovery of overpayments.pdf 8129 Recovery of Overpayment	IC Document
Section 725.544(c) FR 12-20-2000.pdf Section 725.544(c) FR 12-20-2000	IC Document
Part 410 FCMHS Act of 1969, Title IV - BL Benefits.pdf Part 41- FCMHS Act of 1969, Title IV BL Benefits	IC Document
BL Initial Overpayment Letter for OWCP-20.pdf BL Initial Overpayment letter for OWCP-20	IC Document
DOL GILS Record - Federal Empoyee Compensation System.pdf DOL GILS Record FECA Employee Compensation System	IC Document
FECA Form Letter 1.pdf FECA Form Letter 1	IC Document
FECA Form Letter 2.pdf FECA Form Letter 2	IC Document
ESTABLISHMENT DATA ESTABLISHMENT DATA.pdf Establishment Data	IC Document
Characteristics of Minimum Wage Employee.pdf Characteristics of Minimum Wage Employee	IC Document
20 CFR 10.430-10.441.doc 20 CFR 10.430 - 10.441	IC Document
20 CFR 410 Subpart A.doc 20 CFR 410 Subpart A	IC Document
Published FRN 1215-0144.pdf Published FRN 1215-0144	IC Document
20 CFR 410 Subpart B.doc 20 CFR 410 Subpart B	IC Document
20 CFR 410 Subpart C.doc 20 CFR 410 Subpart C	IC Document
20 CFR 410 Subpart D.doc 20 CFR 410 Subpart D	IC Document
20 CFR 410 Subpart E.doc 20 CFR 410 Subpart E	IC Document
20 CFR 410 Subpart F.doc 20 CFR 410 Subpart F	IC Document
20 CFR 410 Subpart G.doc 20 CFR 410 Subpart G	IC Document
Privacy Act Systems - DOL-GOVT-1.pdf DOL/GOVT-1	IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:

Overpayment Recovery Questionnaire

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation: 20 CFR 725.544 (c) 20 CFR 10.430 - 10.441 20 CFR 30.510-520

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	OWCP-20	Overpayment Recovery Questionnaire	owcp-20.pdf	http://www.dol.gov/esa/owcp/dfec/regs/compliance/OWCP-20.pdf	Yes	No	Fillable Printable

Federal Enterprise Architecture Business Reference Module

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records

Title: DOL/GOVT-1, ESA/DOL-6 Black Lung, DOL/ESA-30 Black Lung, DOL/ESA-49 EEOICPA

FR Citation: 67 FR 16869

Number of Respondents: 3,393

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	3,393	305	3,088
Annual IC Time Burden (Hours)	3,393	305	3,088
Annual IC Cost Burden (Dollars)	1,954	472	1,482

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
DOL/ESA-6	DOL Privacy Act systems ESA-6.pdf	08/02/2006
DOL/ESA-30	DOL-ESA-30.pdf	08/02/2006
DOL/ESA-49	DOL ESA-49.pdf	08/02/2006
supporting regulations EEOICPA	Supporting regulations EEOICPA.pdf	08/02/2006
7385j-2	7385j-2.pdf	08/02/2006
30 USC 923b	30 USC 923 (b).pdf	08/02/2006
8129 Recovery of Overpayment	8129 Recovery of overpayments.pdf	08/02/2006
Section 725.544(c) FR 12-20-2000	Section 725.544(c) FR 12-20-2000.pdf	08/02/2006
Part 41- FCMHS Act of 1969, Title IV BL Benefits	Part 410 FCMHS Act of 1969, Title IV - BL Benefits.pdf	08/02/2006
BL Initial Overpayment letter for OWCP-20	BL Initial Overpayment Letter for OWCP-20.pdf	08/02/2006
DOL GILS Record FECA Employee Compensation System	DOL GILS Record - Federal Empoyee Compensation System.pdf	08/02/2006
FECA Form Letter 1	FECA Form Letter 1.pdf	08/02/2006
FECA Form Letter 2	FECA Form Letter 2.pdf	08/02/2006
Establishment Data	ESTABLISHMENT DATA ESTABLISHMENT DATA.pdf	08/02/2006
Characteristics of Minimum Wage Employee	Characteristics of Minimum Wage Employee.pdf	08/02/2006
20 CFR 10.430 - 10.441	20 CFR 10.430-10.441.doc	08/02/2006
20 CFR 410 Subpart A	20 CFR 410 Subpart A.doc	08/02/2006
Published FRN 1215-0144	Published FRN 1215-0144.pdf	08/03/2006
20 CFR 410 Subpart B	20 CFR 410 Subpart B.doc	08/04/2006
20 CFR 410 Subpart C	20 CFR 410 Subpart C.doc	08/04/2006
20 CFR 410 Subpart D	20 CFR 410 Subpart D.doc	08/04/2006
20 CFR 410 Subpart E	20 CFR 410 Subpart E.doc	08/04/2006
20 CFR 410 Subpart F	20 CFR 410 Subpart F.doc	08/04/2006
20 CFR 410 Subpart G	20 CFR 410 Subpart G.doc	08/04/2006
DOL/GOVT-1	Privacy Act Systems - DOL-GOVT-1.pdf	07/28/2009

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