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OWCP_Paper Survey for Soliciting Feedback for DEEOIC from claimants who recently received medical travel reimbursement
Improving Customer Experience (OMB Circular A-11, Section 280 Implementation) for the Department of Labor (DOL)
OMB: 1225-0093
IC ID: 270724
OMB.report
DOL/DM
OMB 1225-0093
ICR 202503-1225-001
IC 270724
( )
Documents and Forms
Document Name
Document Type
OWCP_Paper Survey for Soliciting Feedback for DEEOIC from claimants who recently received medical travel reimbursement
Form and Instruction
Medical Travel Reimbursement Survey
Medical Travel Reimbursement Survey and Cover Letter.docx
Form and Instruction
ICR A11 Section 280 Clearance - DEEOIC Paper Survey Travel Reimbursement_MN_clean.docx
Supporting Statement
IC Document
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
OWCP_Paper Survey for Soliciting Feedback for DEEOIC from claimants who recently received medical travel reimbursement
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
N/A
Medical Travel Reimbursement Survey
Medical Travel Reimbursement Survey and Cover Letter.docx
No
Paper Only
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:
2,000
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
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
2,000
0
0
0
0
2,000
Annual IC Time Burden (Hours)
167
0
0
0
0
167
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
Supporting Statement
ICR A11 Section 280 Clearance - DEEOIC Paper Survey Travel Reimbursement_MN_clean.docx
09/05/2024
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.