View Information Collection (IC)

View Information Collection (IC)

EEOICP Forms for State Governments
No Modified
Required to Obtain or Retain Benefits

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-EEOICP forms for State Government EE-13 and EN-13 (draft for 2013 clearance).docx No   Paper Only

Income Security General Retirement and Disability

DOL/ESA-49  67 FR 16891

2,438 0
State, Local, and Tribal Governments
   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 2,438 0 0 2,387 0 51
Annual IC Time Burden (Hours) 1,833 0 0 1,017 0 816
Annual IC Cost Burden (Dollars) 1,195 0 0 1,195 0 0

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