Information Collection Request
Claim for Reimbursement of Benefit Payments and Claims Expense Under the War Hazards Compensation Act
ICR 202303-1240-003 · OMB 1240-0006 · Received in OIRA
⚠️ Notice: This information collection may be outdated. More recent filings for OMB 1240-0006 can be found here:
Forms and Documents
| Document | Type | Status | Availability |
|---|---|---|---|
 Form CA-278 Claim for Reimbursement of Benefit Payments and Claims Expense Under the War Hazards Compensation Act |
Form and Instruction | Modified | Repair queued |
| General Schedule.mhtml |
Supplementary Document | Uploaded 2023-03-30 | Repair queued |
 81 Fed. Reg. 47418 (July 21, 2016).pdf |
Supplementary Document | Uploaded 2023-03-30 | Repair queued |
 Supporting Statement 1240-0006_2023.docx |
Supporting Statement A | Uploaded 2023-04-25 | Repair queued |
| 5 usc 8147 2023.docx |
Supplementary Document | Uploaded 2023-04-04 | Repair queued |
| 20 cfr 61.104.docx |
Supplementary Document | Uploaded 2023-04-04 | Repair queued |
| 20 cfr 61.101.docx |
Supplementary Document | Uploaded 2023-04-04 | Missing upstream |
IC Document Collections
| IC ID | Collection | Type | Status | Form |
|---|---|---|---|---|
| 13940 |  Claim for Reimbursement of Benefit Payments and Claims Expense Under the War Hazards Compensation Act |
Form and Instruction | Modified |
ICR Details
| Status | Received in OIRA |
|---|---|
| Agency/Subagency | DOL/OWCP |
| OMB Control No | 1240-0006 |
| Type of Information Collection | Extension without change of a currently approved collection |
| Previous ICR Reference No | 202302-1240-004 |
| Date Submitted to OIRA | 1969-12-31 |
| Requested Expiration Date | 1969-12-31 |