Please note that the OMB number and expiration date may not have been determined when this Information Collection Request and associated Information Collection forms were submitted to OMB. The approved OMB number and expiration date may be found by clicking on the Notice of Action link below.

View ICR - OIRA Conclusion

OMB Control No: 1240-0018	ICR Reference No: 201602-1240-007
Status: Historical Active	Previous ICR Reference No: 201301-1240-001
Agency/Subagency: DOL/OWCP	Agency Tracking No:
Title: Claim for Reimbursement-Assisted Reemployment
Type of Information Collection: Revision of a currently approved collection	Common Form ICR: No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 09/14/2016
Retrieve Notice of Action (NOA)	Date Received in OIRA: 07/21/2016
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	09/30/2019	36 Months From Approved	09/30/2016
Responses	128	0	168
Time Burden (Hours)	64	0	84
Cost Burden (Dollars)	67	0	82

ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to Adjustment in Estimate
Annual Number of Responses	128	168	-40
Annual Time Burden (Hours)	64	84	-20
Annual Cost Burden (Dollars)	67	82	-15

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: The adjustments in the burden hours are due to a decrease in the number of participating employers. The previous approved number of annual respondents (42) decreased to approximately (32), which represents a decrease of 10 respondents. The previously approved number of burden hours was 84; the requested number of hours is 64, which is a decrease of 20 hours. In addition, postage and envelope costs, the maintenance and reporting costs is now $67.00, which is a reduction of $15.00, from the previous amount of $82.00.