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

Information Collection (IC) Details

View Information Collection (IC)

OWCP_Paper Survey for Soliciting Feedback for DEEOIC from claimants who recently received medical travel reimbursement
 
Unchanged
 
Voluntary
 

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

Income Security General Retirement and Disability

 

2,000 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 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

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.

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