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Agenda
Reg Review
ICR
View Information Collection (IC)
View Information Collection (IC)
IC Title:
EEOICP Forms for Business or other for profits
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
New
Obligation to Respond:
Required to Obtain or Retain Benefits
CFR Citation:
20 CFR 30.207
20 CFR 30.215
20 CFR 30.103
20 CFR 30.106
20 CFR 30.222
20 CFR 30.415 through 30.417
20 CFR 30.905
20 CFR 30.232 (a) and (b)
20 CFR 30.907
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form and Instruction
EE-7
Department of Energy's Response to Employment History for Claim Under the Energy Employees Occupational Illness Compensation Program Act
EE-7 1215-0197 (2007 clearnace).rtf
No
Printable Only
Form and Instruction
EE-7 Spanish
Department of Energy's Response to Employment History for Claim Under the Energy Employees Occupational Illness Compensation Program Act
EE-7 Spanish 1215-0197 (2007 clearance).pdf
No
Paper Only
Federal Enterprise Architecture Business Reference Module
Line of Business:
Income Security
Subfunction:
General Retirement and Disability
Privacy Act System of Records
Title:
DOL/ESA-49
FR Citation:
67 FR 16891
Number of Respondents:
20,662
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
20,662
0
0
20,662
0
0
Annual IC Time Burden (Hours)
5,291
0
0
5,291
0
0
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.