OWCP DCMWC Customer Experience Survey for Feedback on Claimants who Recently Received a Decision

Improving Customer Experience (OMB Circular A-11, Section 280 Implementation) for the Department of Labor (DOL)

Documents and Forms

Document Name Document Type
OWCP DCMWC Customer Experience Survey for Feedback on Claimants who Recently Received a Decision Form
Black Lung Survey Instructions- Claimants who recently received a decision - 12-2-2024.docx Other-Intro Letter to Form
OWCP DCMWC Customer Experience Survey for Feedback on Cl CX Survey - Claimants who recently received a decision - 12-2-2024.docx Form
DCMWC - ICR _A11 Section 280 Clearance -Recently received a decision 12-2-2024 OCIO1 Clean -KL.docx Supplemental Supporting Statement OWCP DCMWC Customer Experience Survey for Feedback on Claimants who Recently Received a Decisi IC Document

Information Collection (IC) Details

IC Title:	OWCP DCMWC Customer Experience Survey for Feedback on Claimants who Recently Received a Decision	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	N/A	OWCP DCMWC Customer Experience Survey for Feedback on Claimants who Recently Received a Decision	CX Survey - Claimants who recently received a decision - 12-2-2024.docx		No		Paper Only
Other-Intro Letter to Form			Black Lung Survey Instructions- Claimants who recently received a decision - 12-2-2024.docx		No		Paper Only

Line of Business: Workforce Management

Subfunction: Worker Safety

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 500	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Requested	Previously Approved
Annual Number of Responses for this IC	500	500
Annual IC Time Burden (Hours)	42	42
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Supplemental Supporting Statement OWCP DCMWC Customer Experience Survey for Feedback on Claimants who Recently Received a Decision	DCMWC - ICR _A11 Section 280 Clearance -Recently received a decision 12-2-2024 OCIO1 Clean -KL.docx	12/03/2024

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.