Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
EEOICP Forms for Business or other for profits New 20662 5291 0 Form and Instruction EE-7 Department of Energy's Response to Employment History for Claim Under the Energy Employees Occupational Illness Compensation Program Act
Form and Instruction EE-7 Spanish Department of Energy's Response to Employment History for Claim Under the Energy Employees Occupational Illness Compensation Program Act
EEOICP Forms for Federal Government New 51 816 0 Other-Letter
EEOICP Forms for Individuals or Households Modified 58349 29340 4629 Form EE-8 Letter to Claimant
Form EE-9 Letter to Claimant
Form and Instruction EE-4 English Employment History Affidavit for a Claim Under the Energy Employees Occupational Ilness Compensation Program 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 and Instruction EE-3 English Employment History 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-4 Spanish Employment History Affidavit for a Claim 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-20 Letter to Claimant
Form and Instruction EE-1 English Claims for Benefits Under the Energy Employees Occupational Illness Compensation Program Act
Form and Instruction EE-10 Claim for Additional Wage-Loss and/or Impairment Under the Energy Employees Occupational Illness Compensation Act
Other-Letter
Total burden requested under this ICR: 79062 35447 4629  
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