View Information Collection (IC)

View Information Collection (IC)

IC Title:	Operator Controversion, Operator Response, Operator Response to Schedule for Submission of Additional Evidence, and Operator Response to Notice of Claim	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 20 CFR 725.408 20 CFR 725.412

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	CM-2970	Operator Response to Schedule for Submission of Additional Evidence	cm-2970.pdf	http://www.dol.gov/owcp/regs/compliance/cm-2970.pdf	Yes	Yes	Fillable Printable
Form	CM-2970a	Operator Response to Notice of Claim	cm-2970a.pdf	http://www.dol.gov/owcp/regs/compliance/cm-2970a.pdf	Yes	Yes	Fillable Printable

Federal Enterprise Architecture Business Reference Module

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records
Title: DOL/ESA-6	FR Citation: 67 FR 16869

Number of Respondents: 9,600	Number of Respondents for Small Entity: 9,300

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to New Statute	Program Change Due to Agency Discretion	Change Due to Adjustment in Agency Estimate	Change Due to Potential Violation of the PRA	Previously Approved
Annual Number of Responses for this IC	9,600	0	0	0	0	9,600
Annual IC Time Burden (Hours)	2,000	0	0	0	0	2,000
Annual IC Cost Burden (Dollars)	4,704	0	0	192	0	4,512

Documents for IC

Title	Document	Date Uploaded
No associated records found

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.