Paper Survey for Soliciting Feedback for Division of Energy Employees Occupational Illness Compensation (DEEOIC)

Improving Customer Experience (OMB Circular A-11, Section 280 Implementation) for the Department of Labor (DOL)

⚠️ Notice: This information collection may be referencing outdated material.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

Documents and Forms

Document Name Document Type
Paper Survey for Soliciting Feedback for Division of Energy Employees Occupational Illness Compensation (DEEOIC) Form and Instruction
Oxygen and Accessories DME Survey Oxygen and Accessories DME Survey.pdf Form and Instruction
Oxygen and Accessories DME Survey Oxygen and Accessories DME Survey.pdf Form and Instruction
ICR A11 Section 280 Clearance - DEEOIC Paper Survey Oxygen and Supplies June 2023 .docx DEEOIC Paper Survey Oxygen and Supplies IC Document
ICR A11 Section 280 Clearance - DEEOIC Paper Survey Oxygen and Supplies June 2023 .docx DEEOIC Paper Survey Oxygen and Supplies IC Document

Information Collection (IC) Details

IC Title:	Paper Survey for Soliciting Feedback for Division of Energy Employees Occupational Illness Compensation (DEEOIC)	Agency IC Tracking Number:

IC Status: Unchanged

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	N/A	Oxygen and Accessories DME Survey	Oxygen and Accessories DME Survey.pdf		No		Paper Only

Line of Business: Workforce Management

Subfunction: Worker Safety

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 2,000	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Requested	Previously Approved
Annual Number of Responses for this IC	2,000	2,000
Annual IC Time Burden (Hours)	167	167
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
DEEOIC Paper Survey Oxygen and Supplies	ICR A11 Section 280 Clearance - DEEOIC Paper Survey Oxygen and Supplies June 2023 .docx	06/08/2023

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