Information Collection

DOL OWCP Division of Energy Employees Occupational Illness Compensation (DEEOIC) - Web Survey for Soliciting Feedback - Spanish

IC 259320 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⚠️ Notice: This information collection may be referencing outdated material.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
DOL OWCP Division of Energy Employees Occupational Illness Compensation (DEEOIC) - Web Survey for Soliciting Feedback - Spanish	Form and Instruction
Spanish Language Web Feedback Survey Spanish Language Feedback Survey - Spanish.docx	Form and Instruction
Spanish Language Web Feedback Survey Spanish Language Feedback Survey - Spanish.docx	Form and Instruction
ICR - A11 Spanish Language Survey.docx 1225-0093 - DEEOIC Spanish Language Survey	IC Document
ICR - A11 Spanish Language Survey.docx 1225-0093 - DEEOIC Spanish Language Survey	IC Document

IC Title:

DOL OWCP Division of Energy Employees Occupational Illness Compensation (DEEOIC) - Web Survey for Soliciting Feedback - Spanish

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	Spanish Language Web Feedback Survey	Spanish Language Feedback Survey - Spanish.docx		Yes	Yes	Fillable Fileable

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 300

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Requested	Previously Approved
Annual Number of Responses for this IC	300	300
Annual IC Time Burden (Hours)	25	25
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
1225-0093 - DEEOIC Spanish Language Survey	ICR - A11 Spanish Language Survey.docx	03/24/2023

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