EEOICPA Dose Reconstruction Interviews Conclusion Form

Energy Employees Occupational Illness Compensation Program Act Dose Reconstruction Interviews and Forms (EEOICPA)

OMB: 0920-0530

IC ID: 188308

Information Collection (IC) Details

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EEOICPA Dose Reconstruction Interviews Conclusion Form
 
No Unchanged
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form OCAS-1 Statement by Claimant Closing Record on a NIOSH Dose Reconstruction Attachment D.doc Yes No Fillable Printable

Health Consumer Health and Safety

09-20-0147 Occupational Health Epidemiological Studies and EEOICPA Program Records  76 FR 34706

3,600 0
   
Individuals or Households
 
   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 3,600 0 3,600 0 0 0
Annual IC Time Burden (Hours) 300 0 300 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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