Information Collection

OWCP Paper Survey for Soliciting Feedback for DEEOIC from Claimants Who Recently Received Medical Travel Reimbursement

IC 270724 under ICR 202507-1225-002 · OMB 1225-0093.

Documents and Forms

Documents and forms in this information collection
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 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
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
ICR A11 Section 280 Clearance - DEEOIC Paper Survey Travel Reimbursement_MN_clean.docx Supporting Statement	IC Document

IC Title:

Agency IC Tracking Number:

IC Status: Modified

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: 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 %

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
Supporting Statement		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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