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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
600
50
0
Form and Instruction
SI-1C (03-09)
Supplemental Information on Accident and Insurance
Form
ID-30K (03-02)
Notice to Request Supplemental Information on Injury or Illness
Supplemental Information on Accident and Insurance
Modified
16782
842
0
Form and Instruction
SI-5 (12-93)
Report of Payments to Employee Claiming Sickness Benefits Under the RUIA
Form and Instruction
ID-3S (03-09)
Request for Lien Information; Report of Settlement
Form and Instruction
ID-3S-1 (03-09)
Lien Information Under Section 12(o) of the RUIA
Form and Instruction
ID-3U (03-09)
Request for Section 2(f) Information
Form and Instruction
ID-30K-1 (03-02)
Request for Supplemental Information on Injury or Illness - 3rd party
Total burden requested under this ICR:
17382
892
0
To view an IC, click on IC Title
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