Overpayment Recovery Questionnaire

OMB 1240-0051

Information collected with this form is used to evaluate the financial profile of OWCP beneficiaries who have been overpaid benefits, and their ability to repay. OWCP beneficiaries are typically retired coal miners disabled by black lung disease, Federal employees injured on the job, and their survivors.

The latest form for Overpayment Recovery Questionnaire expires 2022-07-31 and can be found here.

Latest Forms, Documents, and Supporting Material

Document Name
Form OWCP-20 Overpayment Recovery Questionnaire Form and Instruction
Supporting Statement 1240-0051 (OWCP-20) 7-22-2022.docx Supporting Statement A
Federal Register Notice - 1240-0051.pdf Supplementary Document
FECARegulationsSec8129.pdf Supplementary Document
FECAoverpaymentregs.doc Supplementary Document
Supporting regulations EEOICPA.doc Supplementary Document
Overpayment Recovery Questionnaire Form and Instruction

All Historical Document Collections

202207-1240-001 Approved without change	Extension without change of a currently approved collection	2022-07-28
201902-1240-001 Approved without change	Extension without change of a currently approved collection	2019-05-01
201507-1240-002 Approved without change	Extension without change of a currently approved collection	2015-12-29
201207-1240-003 Approved without change	Revision of a currently approved collection	2012-10-29
201003-1240-051 Approved without change	Extension without change of a currently approved collection	2010-03-26