OMB control number

Energy Employees Occupational Illness Compensation Program Act Forms (Various)

OMB 1215-0197 · DOL/ESA.

OMB 1215-0197

Latest Forms, Documents, and Supporting Material

Latest forms, documents, and information collections
Document	Type
Form EE-7 Spanish Department of Energy's Response to Employment History for Claim Under the Energy Employees Occupational Illness Compensation Program Act	Form and Instruction
Form EE-7 Department of Energy's Response to Employment History for Claim Under the Energy Employees Occupational Illness Compensation Program Act	Form and Instruction
Form EE-10 Claim for Additional Wage-Loss and/or Impairment Under the Energy Employees Occupational Illness Compensation Act	Form and Instruction
Form EE-1 English Claims for Benefits Under the Energy Employees Occupational Illness Compensation Program Act	Form and Instruction
Form EE-20 Letter to Claimant	Form and Instruction
Form EE-2 English Claim for Survivor Benefits Under the Energy Employees Occupational Illness Compensation Program Act	Form and Instruction
Form EE-4 Spanish Employment History Affidavit for a Claim under the Energy Employees Occupational Illness Compensation Program Act	Form and Instruction
Form EE-2 Spanish Claim for Survivor Benefits Under the Energy Employees Occupational Illness Compensation Program Act	Form and Instruction
Form EE-3 English Employment History for a Claim Under the Energy Employees Occupational Illness Compensation Program Act	Form and Instruction
Form EE-3 Spanish Employment History for a Claim Under the Energy Employees Occupational Illness Compensation Program Act	Form and Instruction
Form EE-1 Spanish Energy Employees Occupational Illness Compensation Program Act Forms. (Various)	Form and Instruction
Form EE-4 English Employment History Affidavit for a Claim Under the Energy Employees Occupational Ilness Compensation Program Act	Form and Instruction
Form EE-9 Letter to Claimant	Form
Form EE-8 Letter to Claimant	Form
SS for revision to 1215-0197 (2007 clearance).pdf	Supporting Statement A
EEOICP Forms for Federal Government	Other-Letter
EEOICP Forms for Business or other for profits	Form and Instruction
EEOICP Forms for Business or other for profits	Form and Instruction
EEOICP Forms for Individuals or Households	Other-Letter
EEOICP Forms for Individuals or Households	Form and Instruction
EEOICP Forms for Individuals or Households	Form and Instruction
EEOICP Forms for Individuals or Households	Form and Instruction
EEOICP Forms for Individuals or Households	Form and Instruction
EEOICP Forms for Individuals or Households	Form and Instruction
EEOICP Forms for Individuals or Households	Form and Instruction
EEOICP Forms for Individuals or Households	Form and Instruction
EEOICP Forms for Individuals or Households	Form and Instruction
EEOICP Forms for Individuals or Households	Form and Instruction
EEOICP Forms for Individuals or Households	Form and Instruction
EEOICP Forms for Individuals or Households	Form
EEOICP Forms for Individuals or Households	Form

All Historical Document Collections

Historical document collections
Reference	Filing	Received	Action
200702-1215-010	Revision of a currently approved collection	2007-06-14	Approved without change
200609-1215-013	No material or nonsubstantive change to a currently approved collection	2006-10-05	Approved without change
200506-1215-001	Revision of a currently approved collection	2005-06-07	Approved without change
200406-1215-007	No material or nonsubstantive change to a currently approved collection	2004-06-07	Approved without change
200406-1215-006	No material or nonsubstantive change to a currently approved collection	2004-06-04	Approved without change
200406-1215-002	Extension without change of a currently approved collection	2004-06-08	Approved without change
200212-1215-002	Revision of a currently approved collection	2002-12-27	Approved without change
200205-1215-003	No material or nonsubstantive change to a currently approved collection	2002-05-22	Approved without change
200105-1215-003	New collection (Request for a new OMB Control Number)	2001-05-25	Approved without change