Request for Employment Information

OMB 1240-0047

This information collection is used to collect information about a claimant's employment. It is necessary to determine continued eligibility for compensation payments under FECA.

The latest form for Request for Employment Information expires 2022-08-31 and can be found here.

Latest Forms, Documents, and Supporting Material

Document Name
Form CA-1027 Request for Employment Information Form and Instruction
2022 OPM Salary Table Rest of US.pdf Supplementary Document
Table B-8. National Average Weekly Wage for Production or Nonsupervisory Workers on Private NonAgricultuarl Payrolls 2021.pdf Supplementary Document
Section 8106 used in 2022.docx Supplementary Document
Supporting Statement 1240-0047 (CA-1027) FINAL OCIO.docx Supporting Statement A
Request for Employment Information Form and Instruction

All Historical Document Collections

202204-1240-001 Approved without change	Revision of a currently approved collection	2022-06-29
201902-1240-002 Approved without change	Revision of a currently approved collection	2019-05-31
201507-1240-003 Approved without change	Revision of a currently approved collection	2016-01-29
201209-1240-004 Approved without change	Revision of a currently approved collection	2012-12-11
201003-1240-047 Approved without change	Extension without change of a currently approved collection	2010-03-12