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Federal forms, ICRs, and supporting documents

Information Collection

OWCP Customer Experience Survey for Feedback on Claimants Who Recently Received a Denied Decision

IC 261458 under ICR 202503-1225-001 · OMB 1225-0093.

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

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OWCP Customer Experience Survey for Feedback on Claimants Who Recently Received a Denied Decision
 
Removed
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Instruction Black Lung Survey- Denied Claim - Instructions Updated 8-2-2023 (002) (003).docx No   Paper Only
Form N/A CX Survey - Denied Claim CX Survey - Denied Claim 8-24-2023 - Final.docx No   Paper Only

Income Security General Retirement and Disability

 

500 0
   
Individuals or Households
 
   0 %

  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 0 0 -500 0 0 500
Annual IC Time Burden (Hours) 0 0 -42 0 0 42
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Supporting Statement 1225-0093 - A11 Section 280 Clearance - Black Lung-Denied Claim 8-2-2023.docx 08/24/2023
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.