Information Collection Request
Authorization Request Form and Certification /Letter of Medical Necessity for Compounded Drugs (OWCP-26)
ICR 202405-1240-007 · OMB 1240-0062 · Received in OIRA
Forms and Documents
| Document | Type | Status | Availability |
|---|---|---|---|
 Form OWCP-26 Authorization Form/Letter of Medical Necessity for Compounded Drugs |
Form and Instruction | New | Repair queued |
 1240-0NEW OWCP Form Auth Req Form and Certi_Ltr of Medical Necessity for Compounded Drugs (OWCP-26)_Supporting Statement_20240529.docx |
Supporting Statement A | Uploaded 2024-05-29 | Repair queued |
IC Document Collections
| IC ID | Collection | Type | Status | Form |
|---|---|---|---|---|
| 267907 |  Authorization Form/Letter of Medical Necessity for Compounded Drugs |
Form and Instruction | New |
ICR Details
| Status | Received in OIRA |
|---|---|
| Agency/Subagency | DOL/OWCP |
| OMB Control No | 1240-0062 |
| Type of Information Collection | New collection (Request for a new OMB Control Number) |
| Date Submitted to OIRA | 1969-12-31 |
| Requested Expiration Date | 1969-12-31 |