View Information Collection (IC)

View Information Collection (IC)

View Information Collection (IC)

IC Title:	Rehablitation Plan and Award	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 20 CFR 702.507 20 CFR 702.506 20 CFR 10.518 20 CFR 10.519

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	OWCP-16	Rehabilitation Plan and Award	OWCP-16(2011Final).pdf	http://www.dol.gov/owcp/dfec/regs/compliance/OWCP-16.pdf	Yes	No	Fillable Printable

Federal Enterprise Architecture Business Reference Module

Line of Business: Workforce Management

Subfunction: Training and Employment

Privacy Act System of Records
Title: DOL/GOVT-1(FECA);DOL/ESA-15(LHWCA)	FR Citation: 67 FR 16815

Number of Respondents: 5,500	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to New Statute	Program Change Due to Agency Discretion	Change Due to Adjustment in Agency Estimate	Change Due to Potential Violation of the PRA	Previously Approved
Annual Number of Responses for this IC	5,500	0	0	-1,500	0	7,000
Annual IC Time Burden (Hours)	2,750	0	0	-750	0	3,500
Annual IC Cost Burden (Dollars)	0	0	0	0	0	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.