EE-32 (Home Health Care Authorization Request)

Division of Energy Employees Occupational Illnesses Compensation (DEEOIC) Authorization Request Forms

OMB: 1240-0060

IC ID: 243779

Information Collection (IC) Details

View Information Collection (IC)

EE-32 (Home Health Care Authorization Request)
 
No Modified
 
Mandatory
 
20 CFR 30.400(a) 20 CFR 30.700 20 CFR 30.403

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction EE-32 Home Health Care Authorization Request 1240-0060 Home Health Care Authorization Request (EE-32).docx https://owcpmed.dol.gov/ Yes Yes Fillable Fileable

Workforce Management Worker Safety

DOL/OWCP-11  81 FR 25765

3,892 390
   
Individuals or Households
 
   100 %

  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 46,704 0 0 0 0 46,704
Annual IC Time Burden (Hours) 7,784 0 0 0 0 7,784
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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