Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
CareerOneStop Customer Experience Form New 1000 50 0 Form and Instruction N/A CareerOneStop Customer Experience Form
CareerOneStop Customer Experience Form New 1000 50 0 Form and Instruction NA CareerOneStop Survey Questions
Customer Experience Survey for Claimants who are Attending Black Lung Outreach Events New 500 42 0 Form NA Customer Experience Survey for Claimants who are Attending Black Lung Outreach Events
Customer Experience and Equity Assessment Survey New 3156 263 0 Form and Instruction NA Customer Experience and Equity Assessment Survey
Customer Interviews for Soliciting Feedback about the Department of Labor Employment and Benefits Security Administration New 15 10 0 Form and Instruction NA EBSA Customer Interviews Discussion Guide
DOL OWCP Division of Energy Employees Occupational Illness Compensation (DEEOIC) - Web Survey for Soliciting Feedback - Spanish New 300 25 0 Form and Instruction NA Spanish Language Web Feedback Survey
DOL OWCP Black Lung - Claimants with Pending Claim New 500 42 0 Form NA OWCP Black Lung CX Survey - Claimants with a Pending Claim
Instruction
DOL OWCP Web Survey for Soliciting Feedback for Division of Energy Employees Occupational Illness Compensation (DEEOIC) Energy Document Portal New 5000 417 0 Form and Instruction NA EDP Survey Update
Electronic Survey for Soliciting Feedback for the Heat Illness Prevention Campaign Newsletter New 10000 500 0 Form Form 1 Electronic Survey for Soliciting Feedback for the Heat Illness Prevention Campaign Newsletter
Employee Training Administration- Job Seeking and Career Advancement Customer Interviews New 31 31 0 Form and Instruction N/A ETA - Job Seeking and Career Advancement Interview Questions
Federal Black Lung Program Customer Experience Survey New 500 83 0 Form NA Federal Black Lung Program Customer Experience Survey
Instruction
OSHA Voluntary Protection Program (VPP) Participants and Special Government Employee Customer Interviews New 18 16 0 Instruction
OWCP Black Lung Worker's Compensation Program End-to-End Experience Customer Interviews New 16 16 0 Instruction
OWCP Customer Experience Survey for Feedback on Claimants Who Recently Received a Denied Decision New 500 42 0 Instruction
Form N/A CX Survey - Denied Claim
OWCP Customer Feedback at Outreach Event for Division of Energy Employees Occupational Illness Compensation (Paper) New 600 50 0 Form and Instruction NA Customer Feedback at Outreach Event for Division of Energy Employees Occupational Illness Compensation (DEEOIC)
OWCP DEEOIC End-to-End Experience Customer Interviews New 16 16 0 Instruction
OWCP DEEOIC Focus Groups New 80 80 0 Instruction
OWCP DEEOIC Outreach Event Feedback Form New 800 67 0 Form N/A OWCP DEEOIC Outreach Event Feedback Form
OWCP DEEOIC Revised Phone Survey New 5000 333 0 Instruction
OWCP Focus groups for collecting customer feedback for Division of Energy Employees Occupational Illness Compensation (DEEOIC) New 120 120 0 Instruction
OWCP Longshore ECOMP - Help Us Improve Our Program New 1620 135 0 Form and Instruction NA Longshore ECOMP - Help us Improve Our Program
OWCP Longshore Voluntary Demographic Information New 1620 135 0 Form and Instruction NA Longshore ECOMP-Instrument (1st Survey)
OWCP Paper Survey for Medical Travel Reimbursement (DEEOIC) New 2000 167 0 Form and Instruction NA Medical Travel Survey
OWCP Paper Survey for Medical Travel Reimbursement (DEEOIC) Removed 2000 167 0 Form and Instruction NA Medical Travel Survey
OWCP Paper Survey for Soliciting Feedback for Division of Energy Employees Occupational Illness Compensation (DEEOIC) from Claimants with Initial Claims for Home Health Care New 4000 333 0 Form and Instruction N/A DEEOIC Home Health Care Survey
OWCP Survey for Soliciting Feedback for Division of Energy Employees Occupational Illness Compensation (DEEOIC) - Final Decision on a Part E Wage Loss/Impairment Claim New 2000 167 0 Form and Instruction N/A DEEOIC Part E Final Decision Survey and Letter
OWCP Web-based Survey for Soliciting Webinar Feedback for Division of Energy Employees Occupational Illness Compensation (DEEOIC) New 4000 333 0 Form and Instruction NA DEEOIC Webinar Survey Language
Paper Survey for Soliciting Feedback for Division of Energy Employees Occupational Illness Compensation (DEEOIC) New 2000 167 0 Form and Instruction 1 DEEOIC Phone Survey
Paper Survey for Soliciting Feedback for Division of Energy Employees Occupational Illness Compensation (DEEOIC) New 2000 167 0 Form and Instruction N/A Oxygen and Accessories DME Survey
Paper Survey for Soliciting Feedback for Division of Energy Employees Occupational Illness Compensation (DEEOIC)from Authorized Representatives New 2000 167 0 Form and Instruction NA DEEOIC Authorized Representative Survey
Paper Survey for Soliciting Feedback for OWCP Division of Energy Employees Occupational Illness Compensation (DEEOIC) from Resource Center Customers New 1500 125 0 Form and Instruction NA DEEOIC Resource Center Customer Service Survey
Phone Survey for Soliciting Feedback for DEEOIC New 5000 333 0 Form and Instruction 1 DEEOIC Phone Survey
Quantitative Web User Experience Testing (Rapid) Survey for Soliciting Feedback for the Department of Labor Employment and Benefits Security Administration Website New 500 167 0 Other-Form, Instruction, and Consent Form
Quantitative Web User Experience Testing (Rapid) Survey for Soliciting Feedback for the Department of Labor Employment and Benefits Security Administration Website New 900 300 0 Form and Instruction NA EBSA Quantitative Web UX Testing Rapid Survey
Recruiting and Screening Customers for Customer Interviews for Soliciting Feedback for the Department of Labor Employment and Benefits Security Administration New 15 3 0 Form and Instruction NA EBSA Customer Interviews Recruitment Screener Questions
Survey for Soliciting Feedback for DEEOIC. New 4000 333 0 Form and Instruction 1 Survey for Soliciting Feedback for DEEOIC.
Tree Testing for Soliciting Feedback for the Department of Labor Employment and Benefits Security Administration Website New 30 15 0 Form and Instruction NA EBSA Tree Testing Baseline Survey
Voluntary Demographic Information New 3156 263 0 Form and Instruction NA Voluntary Demographic Information
Web Survey for Soliciting Feedback for Division of Energy Employees Occupational Illness Compensation (DEEOIC) Energy Document Portal New 7000 350 0 Form and Instruction NA Web Survey for Soliciting Feedback for Division of Energy Employees Occupational Illness Compensation (DEEOIC) Energy Document Portal
Wireframe Testing for Soliciting Feedback for the Department of Labor Employment and Benefits Security Administration Website New 300 75 0 Form and Instruction NA Wireframe Testing for Soliciting Feedback for the Department of Labor EBSA Website
Form and Instruction NA Consent Form for Wireframe Testing for Soliciting Feedback for the Department of Labor EBSA Website
Total Burden Actually Used for Information Collections Under Currently Approved ICR: 74793 6155 0  
Total Burden Currently Requested for Information Collections Under Currently Approved ICR: 0 0 0  
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