Information Collection

Operator Response to Schedule for Submission of Additional Evidence, and Operator Response to Notice of Claim

IC 13697 under ICR 202002-1240-005 · OMB 1240-0033.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1240-0033 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form CM-2970 Operator Response to Schedule for Submission of Additional Evidence, and Operator Response to Notice of Claim	Form
CM-2970 Operator's Response To Schedule for Submission of Additi 20200302 CM-2970.docx www.dol.gov/owcp/regs/compiance/cm-2970	Form
CM-2970a Operator Response to Notice of Claim 20200302 CM-2970a.docx http:www.dol.gov/owcp/regs/compliance/cm-2970a	Form

IC Title:

Operator Response to Schedule for Submission of Additional Evidence, and Operator Response to Notice of Claim

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 20 CFR 725.408(a)(2) 20 CFR 725.412a

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	CM-2970	Operator's Response To Schedule for Submission of Additional Evidence	20200302 CM-2970.docx	http://www.dol.gov/owcp/regs/compiance/cm-2970	Yes	Yes	Fillable Printable
Form	CM-2970a	Operator Response to Notice of Claim	20200302 CM-2970a.docx	http:www.dol.gov/owcp/regs/compliance/cm-2970a	Yes	Yes	Fillable Printable

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records

Title: DOL/OWCP-2 and DOL/OWCP-9

FR Citation: 81 FR 25858

Number of Respondents: 4,900

Number of Respondents for Small Entity: 4,900

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 50 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	9,800	200	9,600
Annual IC Time Burden (Hours)	2,042	42	2,000
Annual IC Cost Burden (Dollars)	2,842	-1,958	4,800

Documents for IC

table that charts IC Documents
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.