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Federal forms, ICRs, and supporting documents

Information Collection

Rehabilitation Maintenance Certificate

IC 43809 under ICR 202502-1240-004 · OMB 1240-0012.

Documents and Forms
Document Name
Document Type
Form
Form
Form
Form
Information Collection (IC) Details

View Information Collection (IC)

Rehabilitation Maintenance Certificate
 
No Modified
 
Required to Obtain or Retain Benefits
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form OWCP-17 Rehabilitation Maintenance Certificate owcp-17 with proposed changes.pdf http://www.dol.gov/owcp/dfec/regs/compliance/forms.htm Yes No Fillable Printable

Workforce Management Training and Employment

DOL/GOVT-1 (FECA); DOL/OWCP-3; DOL/OWCP-4 (Longshore)  81 FR 47418

148 0
   
Individuals or Households
 
   100 %

  Approved 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 1,288 0 -2,164 0 0 3,452
Annual IC Time Burden (Hours) 215 0 -360 0 0 575
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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