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Agenda
Reg Review
ICR
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
To view an IC, click on IC Title