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: 201202-1240-002
Status: Historical Active	Previous ICR Reference No: 201003-1240-001
Agency/Subagency: DOL/OWCP	Agency Tracking No:
Title: Statement of Recovery Forms
Type of Information Collection: Revision of a currently approved collection	Common Form ICR: No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 08/07/2012
Retrieve Notice of Action (NOA)	Date Received in OIRA: 05/11/2012
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	08/31/2015	36 Months From Approved	08/31/2012
Responses	2,832	0	3,000
Time Burden (Hours)	1,346	0	1,425
Cost Burden (Dollars)	1,360	0	1,350

ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to Adjustment in Estimate
Annual Number of Responses	2,832	3,000	-168
Annual Time Burden (Hours)	1,346	1,425	-79
Annual Cost Burden (Dollars)	1,360	1,350	10

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, 3,000 is being reduced to 2,832 which represent a reduction of 168. The approved number of hours is 1,425 and the requested number of hours is 1, 346, a decrease of 79. However, due to an increase in maintenance and reporting costs, this figure has been adjusted by $10.00, from $1,350 to $1,360.