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Claims Under the Radiation Exposure Compensation Act (RECA)
Claims Under the Radiation Exposure Compensation Act (RECA)
OMB: 1105-0052
IC ID: 11747
OMB.report
DOJ/LA
OMB 1105-0052
ICR 202602-1105-001
IC 11747
( )
Documents and Forms
Document Name
Document Type
no available documents/forms check other ICs listed under this ICR
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Claims Under the Radiation Exposure Compensation Act (RECA)
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Unchanged
Obligation to Respond:
Required to Obtain or Retain Benefits
CFR Citation:
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form and Instruction
OMB Number 1105-0052
RECA Uranium Mine
RECA Uranium Mine_revised_091311.pdf
http://www.usdoj.gov/civil/torts/const/reca/claimform.htm
Yes
No
Printable Only
Form and Instruction
OMB Number 1105-0052
RECA Uranium Ore
RECA Uranium Ore_revised_091311.pdf
http://www.usdoj.gov/civil/torts/const/reca/claimform.htm
Yes
No
Printable Only
Form and Instruction
OMB 1105-0052
RECA Downwinder Claim Form
RECA DOWNWINDER CLAIM FORM_25_07_23.docx
Yes
Yes
Fillable Fileable
Form and Instruction
OMB #1105-0052
RECA onsite participant claim form
RECA ONSITE PARTICIPANT CLAIM FORM_25_07_23.docx
Yes
Yes
Fillable Fileable
Form and Instruction
OMB #1103-0052
RECA Uranium Worker Claim Form
RECA URANIUM WORKER CLAIM FORM_25_07_23 jcb.docx
Yes
Yes
Fillable Fileable
Form and Instruction
OMB #1103-0052
RECA Manhattan Project Waste Claim Form
RECA MANHATTAN PROJECT WASTE CLAIM FORM_25_07_23.docx
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Litigation and Judicial Activities
Subfunction:
Resolution Facilitation
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
70,000
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
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
70,000
0
0
0
0
70,000
Annual IC Time Burden (Hours)
87,500
0
0
0
0
87,500
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
No associated records found
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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