Information Collection

OWCP DEEOIC Outreach Event Feedback Form

IC 258583 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⚠️ Notice: This information collection may be referencing outdated material.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 DEEOIC Outreach Event Feedback Form	Form
OWCP DEEOIC Outreach Event Feedback Form Outreach Event Feedback Form.pdf	Form
OWCP DEEOIC Outreach Event Feedback Form Outreach Event Feedback Form.pdf	Form
ICR A11 Section 280 Clearance - DEEOIC Outreach Event Survey.docx OWCP DEEOIC Outreach Event Feedback Form - Supplementary Supporting Statement	IC Document
ICR A11 Section 280 Clearance - DEEOIC Outreach Event Survey.docx OWCP DEEOIC Outreach Event Feedback Form - Supplementary Supporting Statement	IC Document

IC Title:

OWCP DEEOIC Outreach Event Feedback Form

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	N/A	OWCP DEEOIC Outreach Event Feedback Form	Outreach Event Feedback Form.pdf		No		Paper Only

Line of Business: Income Security

Subfunction: Survivor Compensation

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 800

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	800	800
Annual IC Time Burden (Hours)	67	67
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
OWCP DEEOIC Outreach Event Feedback Form - Supplementary Supporting Statement	ICR A11 Section 280 Clearance - DEEOIC Outreach Event Survey.docx	02/15/2023

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