PO Box Address change for the
EE-8/EN-8, EE-9/EN-9, EE-10/EN-10, EE-11A/EN-11A, EE-11B/EN-11B,
EE-12/EN-12 and EE-16/EN-16 only. The Energy Employee forms are
required to determine a claimant's eligibility for compensation
under the Energy Employee Occupation Illness Compensation Program
Act and are required to enable eligible claimants to receive
benefits.
US Code:
42 USC 7385(s) through 11 Name of Law: Energy Employees
Occupational Illness Compensation Program Act of 2000
US Code: 42
USC 7384 Name of Law: Energy Employees Occupational Illness
Compensation Program Act of 2000
EE-20 and EN-20, EE-4 Spanish, EE_10 and EN-10, EE-2 Spanish,
EE-1 Spanish, EE-3 English, EE-3 Spanish, EE-1 English, EE-2
English, EE-4 English, EE-9 and EN-9, Form EE-8 and EN-8, EE-11A
and EN-11A, EE-11B and EN-11B, EE-12 and EN-12, EE-16 and EN-16,
EE-17B, EE-17A
There is an overall adjustment
of -180 in burden hours due to a decrease in the number of claims
being adjudicated, balanced against an increase in the amount of
information required by some of those claims, and the new EE-17A
and EE-17B. There has also been a slight increase in the operation
and maintenance costs of +$4,534, due to an increase in the number
of mailed responses, from $27,800 to $32,334.
On behalf of this Federal agency, I certify that
the collection of information encompassed by this request complies
with 5 CFR 1320.9 and the related provisions of 5 CFR
1320.8(b)(3).
The following is a summary of the topics, regarding
the proposed collection of information, that the certification
covers:
(i) Why the information is being collected;
(ii) Use of information;
(iii) Burden estimate;
(iv) Nature of response (voluntary, required for a
benefit, or mandatory);
(v) Nature and extent of confidentiality; and
(vi) Need to display currently valid OMB control
number;
If you are unable to certify compliance with any of
these provisions, identify the item by leaving the box unchecked
and explain the reason in the Supporting Statement.
Form EE-13 with EN-13 EEOICP Forms for State Governments
Justification - EE8 with EN 8EE-8 EN-8, EE-9 EN-9, EE-10 EN-10, EE-11A EN-11A, EE-11B EN-11B, EE-12 EN-12 and EN-16 EN16.docx
EE-11B with EN-11B.pdf
EEOICP Forms for State Governments