View Information Collection Request (ICR) Package

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View ICR - OIRA Conclusion

OMB Control No: 1240-0029	ICR Reference No: 201412-1240-009
Status: Historical Inactive	Previous ICR Reference No: 201409-1240-002
Agency/Subagency: DOL/OWCP	Agency Tracking No:
Title: Request for Examination and/or Treatment
Type of Information Collection: No material or nonsubstantive change to a currently approved collection	Common Form ICR: No
Type of Review Request: Regular
OIRA Conclusion Action: Preapproved	Conclusion Date: 05/15/2015
	Date Received in OIRA: 03/12/2015
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	08/31/2017	08/31/2017	08/31/2017
Responses	96,000	0	96,000
Time Burden (Hours)	52,000	0	52,000
Cost Burden (Dollars)	2,085,715	0	2,088,960

ICR Summary of Burden

	Total Request	Previously Approved	Change Due to Agency Discretion
Annual Number of Responses	96,000	96,000	0
Annual Time Burden (Hours)	52,000	52,000	0
Annual Cost Burden (Dollars)	2,085,715	2,088,960	-3,245

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:

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