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Agenda
Reg Review
ICR
Information Collection List
IC Title
Status
Responses
Hours
Dollars
Document Type
Form No.
Form Name
Supplemental Information on Accident and Insurance
Modified
3000
250
0
Form and Instruction
SI-1C (03-02)
Supplemental Information on Accident and Insurance
Form and Instruction
SI-1c (proposed)
Supplemental Information on Accident and Insurance
Form
ID-30K (03-02)
Form Letter Asking Claimant for Additional Information on Injury or Illness
Supplemental Information on Accident and Insurance
New
25500
1443
0
Form and Instruction
SI-5 (12-93)
Report of Payments to Employee Claiming Sickness Benefits Under the RUIA
Form and Instruction
ID-3S (06-05)
Request for Lien Information
Form and Instruction
ID-3S-1
Lien Information Under Section 12(o) of the RUIA
Form and Instruction
ID-3U (03-02)
Request for Section 2(f) Information
Form and Instruction
ID-30K-1 (03-02)
Request for Supplemental Information on Injury or Illness - 3rd party
Form and Instruction
ID-3s (proposed)
Request for Lien Information
Form and Instruction
ID-3S-1 (proposed)
Request for Lien Information, Report of Settlement of Third Party Liability Cases
Form and Instruction
ID-3U (proposed)
Request for Section 2(f) Information
Total burden requested under this ICR:
28500
1693
0
To view an IC, click on IC Title
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