Disclosure of Medical Evidence

Disclosure of Medical Evidence

OMB: 1240-0054

IC ID: 216185

Documents and Forms
Document Name
Document Type
no available documents/forms check other ICs listed under this ICR
Information Collection (IC) Details

View Information Collection (IC)

Disclosure of Medical Evidence
 
No Modified
 
Mandatory
 
20 CFR 725.413

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

Income Security General Retirement and Disability

DOL/OWCP-2  67 FR 16869

7,465 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 7,465 0 0 3,391 0 4,074
Annual IC Time Burden (Hours) 1,244 0 0 565 0 679
Annual IC Cost Burden (Dollars) 13,138 0 0 6,457 0 6,681

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.

© 2024 OMB.report | Privacy Policy