Information Collection

OWCP Longshore Voluntary Demographic Information

IC 253908 under ICR 202312-1225-004 · 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⚠️ Notice: This information collection may be referencing outdated material.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
OWCP Longshore Voluntary Demographic Information	Form and Instruction
Longshore ECOMP-Instrument (1st Survey) Longshore ECOMP-Instrument (1st Survey).docx	Form and Instruction
Longshore ECOMP-Instrument (1st Survey) Longshore ECOMP-Instrument (1st Survey).docx	Form and Instruction
1225-0093 - Supporting Statement 5-25-22.docx Supporting Statement - A11 Section 280 Clearance - Longshore ECO Survey	IC Document
1225-0093 - Supporting Statement 5-25-22.docx Supporting Statement - A11 Section 280 Clearance - Longshore ECO Survey	IC Document

IC Title:

OWCP Longshore Voluntary Demographic Information

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	Longshore ECOMP-Instrument (1st Survey)	Longshore ECOMP-Instrument (1st Survey).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: 1,620

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	1,620	1,620
Annual IC Time Burden (Hours)	135	135
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Supporting Statement - A11 Section 280 Clearance - Longshore ECO Survey	1225-0093 - Supporting Statement 5-25-22.docx	05/26/2022

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