Information Collection

Claims Under the Radiation Exposure Compensation Act (RECA)

IC 11747 under ICR 202602-1105-001 · OMB 1105-0052.

Documents and Forms

Document Name Document Type
Form OMB Number 1105-00 RECA Uranium Mine Claims Under the Radiation Exposure Compensation Act (RECA) Form and Instruction
Form OMB Number 1105-00 RECA Uranium Ore Claims Under the Radiation Exposure Compensation Act (RECA) Form and Instruction
Form OMB 1105-0052 RECA Downwinder Claim Form Claims Under the Radiation Exposure Compensation Act (RECA) Form and Instruction
Form OMB #1105-0052 RECA onsite participant claim form Claims Under the Radiation Exposure Compensation Act (RECA) Form and Instruction
Form OMB #1103-0052 RECA Uranium Worker Claim Form Claims Under the Radiation Exposure Compensation Act (RECA) Form and Instruction
Form OMB #1103-0052 RECA Manhattan Project Waste Claim Form Claims Under the Radiation Exposure Compensation Act (RECA) Form and Instruction
OMB Number 1105-00 RECA Uranium Mine RECA Uranium Mine_revised_091311.pdf www.usdoj.gov/civil/torts/const/reca/claimform.htm Form and Instruction
OMB Number 1105-00 RECA Uranium Ore RECA Uranium Ore_revised_091311.pdf www.usdoj.gov/civil/torts/const/reca/claimform.htm Form and Instruction
OMB 1105-0052 RECA Downwinder Claim Form RECA DOWNWINDER CLAIM FORM_25_07_23.docx Form and Instruction
OMB #1105-0052 RECA onsite participant claim form RECA ONSITE PARTICIPANT CLAIM FORM_25_07_23.docx Form and Instruction
OMB #1103-0052 RECA Uranium Worker Claim Form RECA URANIUM WORKER CLAIM FORM_25_07_23 jcb.docx Form and Instruction
OMB #1103-0052 RECA Manhattan Project Waste Claim Form RECA MANHATTAN PROJECT WASTE CLAIM FORM_25_07_23.docx Form and Instruction

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 %

	Approved	Previously Approved
Annual Number of Responses for this IC	70,000	70,000
Annual IC Time Burden (Hours)	87,500	87,500
Annual IC Cost Burden (Dollars)	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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