Information Collection

Paper Survey for Soliciting Feedback for OWCP Division of Energy Employees Occupational Illness Compensation (DEEOIC) from Resource Center Customers

IC 255605 under ICR 202308-1225-003 · OMB 1225-0093.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1225-0093 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Paper Survey for Soliciting Feedback for OWCP Division of Energy Employees Occupational Illness Compensation (DEEOIC) from Resource Center Customers	Form and Instruction
DEEOIC Resource Center Customer Service Survey Resource Center Survey.pdf	Form and Instruction
DEEOIC Resource Center Customer Service Survey Resource Center Survey.pdf	Form and Instruction
ICR A11 Section 280 Clearance - DEEOIC Resource Center Survey August 2022.docx DEEOIC Resource Center Customer Service Survey - Supporting Statement	IC Document
ICR A11 Section 280 Clearance - DEEOIC Resource Center Survey August 2022.docx DEEOIC Resource Center Customer Service Survey - Supporting Statement	IC Document

IC Title:

Paper Survey for Soliciting Feedback for OWCP Division of Energy Employees Occupational Illness Compensation (DEEOIC) from Resource Center Customers

Agency IC Tracking Number:

IC Status: Unchanged

Obligation to Respond: Voluntary

CFR Citation:

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 and Instruction	NA	DEEOIC Resource Center Customer Service Survey	Resource Center Survey.pdf		No		Paper Only

Line of Business: Income Security

Subfunction: Unemployment Compensation

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 1,500

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Requested	Previously Approved
Annual Number of Responses for this IC	1,500	1,500
Annual IC Time Burden (Hours)	125	125
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
DEEOIC Resource Center Customer Service Survey - Supporting Statement	ICR A11 Section 280 Clearance - DEEOIC Resource Center Survey August 2022.docx	08/26/2022

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.