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OWCP Longshore Voluntary Demographic Information
Improving Customer Experience (OMB Circular A-11, Section 280 Implementation) for the Department of Labor (DOL)
OMB: 1225-0093
IC ID: 253908
OMB.report
DOL/DM
OMB 1225-0093
ICR 202312-1225-004
IC 253908
( )
Documents and Forms
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
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
OWCP Longshore Voluntary Demographic Information
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
NA
Longshore ECOMP-Instrument (1st Survey)
Longshore ECOMP-Instrument (1st Survey).docx
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
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 %
Requested
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
1,620
0
0
0
0
1,620
Annual IC Time Burden (Hours)
135
0
0
0
0
135
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
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.