View Information Collection (IC)

View Information Collection (IC)

EEOICP Forms for Private Sector
No Modified
Required to Obtain or Retain Benefits
20 CFR 30.215 20 CFR 30.222 20 CFR 30.415 through 30.417 20 CFR 30.207 20 CFR 30.905 20 CFR 30.232 (a) and (b) 20 CFR 30.907 20 CFR 30.103 20 CFR 30.106

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction EE-7 English Medial Requirements under rhe Energy Employees Occupational Illness Compensation Program Act EE-7 (draft for 2013 clearance).docx No   Paper Only
Form and Instruction EE-7 Spanish Requisitos medicos segun la Ley del Programa de Indemnizacion por Enfermedades Ocupacionales para Empleados del Sector de la Energia EE-7-Spa (draft for 2013 clearance).docx No   Paper Only

Income Security General Retirement and Disability

DOL/ESA-49  67 FR 16891

7,525 0
Private Sector Businesses or other for-profits
   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 7,525 0 0 -179 0 7,704
Annual IC Time Burden (Hours) 1,881 0 0 -92 0 1,973
Annual IC Cost Burden (Dollars) 3,687 0 0 3,687 0 0

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