Please note that the OMB number and expiration date may not have been determined when this Information Collection Request and associated Information Collection forms were submitted to OMB. The approved OMB number and expiration date may be found by clicking on the Notice of Action link below.

View ICR - OIRA Conclusion

OMB Control No: 1240-0001	ICR Reference No: 201003-1240-001
Status: Historical Active	Previous ICR Reference No: 200604-1215-003
Agency/Subagency: DOL/OWCP	Agency Tracking No:
Title: Statement of Recovery Forms
Type of Information Collection: Extension without change of a currently approved collection	Common Form ICR: No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 03/12/2010
Retrieve Notice of Action (NOA)	Date Received in OIRA: 03/12/2010
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	06/30/2012	36 Months From Approved
Responses	3,000	0	3,200
Time Burden (Hours)	1,425	0	1,520
Cost Burden (Dollars)	1,350	0	1,000

ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to Adjustment in Estimate
Annual Number of Responses	3,000	3,200	-200
Annual Time Burden (Hours)	1,425	1,520	-95
Annual Cost Burden (Dollars)	1,350	1,000	350

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: The adjustments in the burden hours are due to a decrease in the number of third party claims. The previous approved number of annual responses, 3200, is being reduced to 3,000, which represents a reduction of 200 respondents. The approved number of hours is 1520 and the requested number of hours is 1425,a decrease of 95. In addition, due to an increase in postage, the maintenance and reporting costs have increased from $1,000 to $1,350, which is an increase of $350.00.