ICR Documents

Supporting Statement A Document Date Uploaded 1240-0044 Supporting Statement _20240611_MN clean.docx 06/11/2024 Supporting Statement B Document Date Uploaded Supplementary Documents Title Document Document Type Date Uploaded Supporting Regs (1240-0044) (OWCP-1500) 20 CFR 10.801 FECA - Supporting Reg.doc Supplementary Document 10/23/2012 Supporting Regs. (1240-0044) (OWCP-1500) 20 CFR 30.701 EEOICPA Supporting Reg.doc Supplementary Document 10/23/2012 Supporting Regs. (1240-0044) (OWCP-1500) 20 CFR 725.405 BLBA Supporting Reg.doc Supplementary Document 10/23/2012 Privacy Act System of Records Privacy Act System of Records - FEC.docx Supplementary Document 09/09/2020 Health Insurance Claim Form (OWCP-1500) 1240-0044 Health Insurance Claim Form (OWCP- 1500)_Revised.pdf Supplementary Document 03/28/2025 No material/Nonsubstantive Change Request for 1240-0044 Justification - 1240-0044 Health Insurance Claim Form (OWCP-1500).docx Justification for No Material/Nonsubstantive Change 03/27/2025 Public Comments Author Name Comment Document Author Affiliation Sponsoring Org. Type Category Date of Comment Date Comment Received