Skip to main content
An official website of the United States government
The .gov means it's official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you're on a federal government site.
The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.
Search:
Agenda
Reg Review
ICR
Information Collection List
IC Title
Status
Responses
Hours
Dollars
Document Type
Form No.
Form Name
Energy Employees Occupational Illness Compensation Program Act Forms (Various)
Modified
92763
41378
22000
Form and Instruction
EE-7 Spanish
Medical Requirements under the Energy Employees Occupational Illness Compensation Act
Form and Instruction
EE-1 Spanish
Energy Employees Occupational Illness Compensation Program Act Forms. (Various)
Form and Instruction
EE-3 Spanish
Employment History for a Claim Under the Energy Employees Occupational Illness Compensation Program Act
Form
EE-4 Spanish
Employment History Affidavit for a Claim under the Energy Employees Occupational Illness Compensation Program Act
Form and Instruction
EE-2 Spanish
Claim for Survivor Benefits Under the Energy Employees Occupational Illness Compensation Program Act
Form and Instruction
EE-1 English
Claims for Benefits Under the Energy Employees Occupational Illness Compensation Program Act
Form and Instruction
EE-2 English
Claim for Survivor Benefits Under the Energy Employees Occupational Illness Compensation Program Act
Form and Instruction
EE-3 English
Employment History for a Claim Under the Energy Employees Occupational Illness Compensation Program Act
Form
EE-4 English
Employment History Affidavit for a Claim Under the Energy Employees Occupational Ilness Compensation Program Act
Form
EE-7 English
Medical Requirements under the Energy Employees Occupational Illness Compensation Program ACt
Form
EE-8
Letter to Claimant
Form
EE-9
Letter to Claimant
Form and Instruction
EE-20
Letter to Claimant
Form and Instruction
EE-10
Claim for Additional Wage-Loss and/or Impairment Under the Energy Employees Occupational Illness Compensation Act
Total burden requested under this ICR:
92763
41378
22000
To view an IC, click on IC Title