ICR Documents

Supporting Statement A Document Date Uploaded Supporting statement 1240-0002 2019 DEEOIC RuleMaking.docx 02/01/2019 Supporting Statement B Document Date Uploaded Supplementary Documents Title Document Document Type Date Uploaded Supporting Regulations Supporting Regulations.pdf Supplementary Document 06/11/2013 EE-8/EN-8: Smoking History Form EE-8 with EN-8.docx Supplementary Document 02/24/2020 EE-9/EN-9: Racial/Ethnic Identification Form EE-9 with EN-9.docx Supplementary Document 02/24/2020 EE-10/EN-10 Claim for Additional WL and/or IMP form EE-10 with EN-10.pdf Supplementary Document 02/24/2020 EE-11A/EN-11A: Response Requested-Impairment Benefits Response Form EE-11 with EN-11.pdf Supplementary Document 02/24/2020 EE-11B/EN-11B: Wage Loss Letter & Response Form EE-11B with EN-11B.pdf Supplementary Document 02/24/2020 EE-12/EN-12: Request for Update - State Workers' Compensation EE-12 with EN-12.docx Supplementary Document 02/24/2020 EE-16/EN-16: Compensation Payment Questionnaire EE-16 with EN-16.docx Supplementary Document 02/24/2020 Justification for No material/Nonsubstantive Change for Energy Forms Justification - EE8 with EN 8EE-8 EN-8, EE-9 EN-9, EE-10 EN-10, EE-11A EN-11A, EE-11B EN-11B, EE-12 EN-12 and EN-16 EN16.docx Justification for No Material/Nonsubstantive Change 02/24/2020 Justification for No material/Nonsubstantive Change for EE1, EE-1-SPA, EE-2, EE-2-SPA, EE-17A and EE-17B Justification EE-1 EE-1 SPA EE-2 EE-2 SPA EE-17 and EE-17B.docx Justification for No Material/Nonsubstantive Change 04/08/2020 Public Comments Author Name Comment Document Author Affiliation Sponsoring Org. Type Category Date of Comment Date Comment Received