Information Collection

Paper Survey for Soliciting Feedback for Division of Energy Employees Occupational Illness Compensation (DEEOIC)

IC 260593 under ICR 202507-1225-002 · OMB 1225-0093.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Paper Survey for Soliciting Feedback for Division of Energy Employees Occupational Illness Compensation (DEEOIC)	Form and Instruction
Oxygen and Accessories DME Survey Paper Survey for Soliciting Feedback for Division of Energy Employees Occupational Illness Compensation (DEEOIC)	Form and Instruction
Oxygen and Accessories DME Survey Oxygen and Accessories DME Survey.pdf	Form and Instruction
Oxygen and Accessories DME Survey Oxygen and Accessories DME Survey.pdf	Form and Instruction
ICR A11 Section 280 Clearance - DEEOIC Paper Survey Oxygen and Supplies June 2023 .docx DEEOIC Paper Survey Oxygen and Supplies	IC Document
ICR A11 Section 280 Clearance - DEEOIC Paper Survey Oxygen and Supplies June 2023 .docx DEEOIC Paper Survey Oxygen and Supplies	IC Document

IC Title:

Agency IC Tracking Number:

IC Status: Unchanged

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	N/A				No		Paper Only

Line of Business: Workforce Management

Subfunction: Worker Safety

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 %

table that charts list of burden
	Requested	Previously Approved
Annual Number of Responses for this IC	2,000	2,000
Annual IC Time Burden (Hours)	167	167
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
DEEOIC Paper Survey Oxygen and Supplies		06/08/2023

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

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