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

View Information Collection (IC)

FECA Medical Report Form
 
No New
 
Required to Obtain or Retain Benefits
 
20 CFR 10.332 20 CFR 10.330 20 CFR 10.501

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction CA-21 http://www.dol.gov/owcp/dfec/regs/compliance/forms.htm Yes No Fillable Printable

Workforce Management Labor Rights Management

DOL/GOVT-1   81 FR 47418

33,372 0
   
Private Sector Businesses or other for-profits
 
   25 %

  Requested 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 33,372 0 33,372 0 0 0
Annual IC Time Burden (Hours) 2,670 0 2,670 0 0 0
Annual IC Cost Burden (Dollars) 20,774 0 20,774 0 0 0

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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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