View Information Collection (IC)
View Information Collection (IC)

View Information Collection (IC)

Energy Employees Occupational Illness Compensation Program Act Forms (Various)
 
No Modified
 
Voluntary
 
20 CFR 30.101 20 CFR 30.103 20 CFR 30.111-114 20 CFR 30.206-207 20 CFR 30.212-215 20 CFR 30.221-222 20 CFR 30.415-417 20 CFR 30.100 20 CFR 30.505 20 CFR 30.620

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction EE-7 Spanish No   Paper Only
Form and Instruction EE-1 Spanish Yes Yes Fillable Fileable Signable
Form and Instruction EE-3 Spanish Yes Yes Fillable Fileable Signable
Form EE-4 Spanish Yes Yes Fillable Fileable Signable
Form and Instruction EE-2 Spanish Yes Yes Fillable Fileable Signable
Form and Instruction EE-1 English http://www.dol.gov./esa/regs/compliance/owcp/eeoicp/clainsforms.htm Yes Yes Fillable Fileable Signable
Form and Instruction EE-2 English http://www.dol.gov/esa/regs/compliance/owcp/eeoicp/claimsforms.htm Yes Yes Fillable Fileable Signable
Form and Instruction EE-3 English http://www.dol.gov/esa/regs/compliance/owcp/eeoicp/claimsforms.htm Yes Yes Fillable Fileable Signable
Form EE-4 English http://www.dol.gov/esa/regs/compliance/owcp/eeoicp/claimsforms.htm Yes Yes Fillable Fileable Signable
Form EE-7 English No   Paper Only
Form EE-8 No   Paper Only
Form EE-9 No   Paper Only
Form and Instruction EE-20 Yes Yes Fillable Fileable Signable
Form and Instruction EE-10 No   Paper Only


 

90,863 0
   
Individuals or Households
 
   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 92,763 0 0 0 0 92,763
Annual IC Time Burden (Hours) 41,378 0 0 0 0 41,378
Annual IC Cost Burden (Dollars) 22,000 0 0 0 0 22,000

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