Information Collection

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

IC 272747 under ICR 202507-1225-002 · OMB 1225-0093.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
OWCP DCMWC Customer Experience Survey for Feedback on Claimants who Recently Received a Decision	Form
OWCP DCMWC Customer Experience Survey for Feedback on Claimants who Recently Received a Decision 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
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
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
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

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	N/A				No		Paper Only
Other-Intro Letter to Form					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 %

table that charts list of burden
	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

table that charts IC Documents
Title	Document	Date Uploaded
Supplemental Supporting Statement OWCP DCMWC Customer Experience Survey for Feedback on Claimants who Recently Received a Decision		12/03/2024

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

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