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Federal forms, ICRs, and supporting documents

Information Collection

OWCP Paper Survey for Soliciting Feedback for Division of Energy Employees Occupational Illness Compensation (DEEOIC) from Claimants with Initial Claims for Home Health Care

IC 256742 under ICR 202504-1225-002 · OMB 1225-0093.

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Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
IC Document
IC Document
IC Document
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Information Collection (IC) Details

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OWCP Paper Survey for Soliciting Feedback for Division of Energy Employees Occupational Illness Compensation (DEEOIC) from Claimants with Initial Claims for Home Health Care
 
Unchanged
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction N/A DEEOIC Home Health Care Survey Home Health Care Survey.pdf No   Paper Only

Income Security Unemployment Compensation

 

4,000 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 4,000 0 0 0 0 4,000
Annual IC Time Burden (Hours) 333 0 0 0 0 333
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Home Health Care Cover Letter Home Health Care Cover Letter.docx 11/14/2022
ICR A11 Section 280 Clearance - DEEOIC Home Health Care ICR A11 Section 280 Clearance - DEEOIC Paper Survey HHC November 2022.docx 11/14/2022
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.