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View ICR - OIRA Conclusion

OMB Control No: 1240-0021	ICR Reference No: 201601-1240-007
Status: Historical Active	Previous ICR Reference No: 201507-1240-001
Agency/Subagency: DOL/OWCP	Agency Tracking No:
Title: Provider Enrollment Form
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: 05/17/2016
Retrieve Notice of Action (NOA)	Date Received in OIRA: 01/29/2016
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	05/31/2019	36 Months From Approved	05/31/2016
Responses	31,979	0	53,934
Time Burden (Hours)	4,252	0	7,174
Cost Burden (Dollars)	16,629	0	25,888

ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to Adjustment in Estimate
Annual Number of Responses	31,979	53,934	-21,955
Annual Time Burden (Hours)	4,252	7,174	-2,922
Annual Cost Burden (Dollars)	16,629	25,888	-9,259

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: There has been a decrease in the number of respondents seeking to provide medical or vocational services to beneficiaries. Accordingly, the burden hours decreased from 7,174 to 4,252, an adjustment of 2,922 hours and the operational and maintenance costs decreased from $25,888 to $16,629, an adjustment of $9,259. While not affecting burden estimates, we updated the form OWCP-1168 including: provider letter, privacy act statement, several items on the form and instructions.