View Information Collection Request (ICR) Package

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: 1240-0045	ICR Reference No: 202008-1240-056
Status: Historical Active	Previous ICR Reference No: 201706-1240-002
Agency/Subagency: DOL/OWCP	Agency Tracking No:
Title: Rehabilitation Plan and Award
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: 01/28/2021
	Date Received in OIRA: 12/01/2020
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	01/31/2024	36 Months From Approved	01/31/2021
Responses	3,176	0	3,913
Time Burden (Hours)	1,588	0	1,957
Cost Burden (Dollars)	0	0	0

ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to Adjustment in Estimate
Annual Number of Responses	3,176	3,913	-737
Annual Time Burden (Hours)	1,588	1,957	-369
Annual Cost Burden (Dollars)	0	0	0

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: Over the last three fiscal years (FY 2014 - 2016), open rehabilitation cases have averaged 3,913 per year, which is 677 less than the number reported (4,590) for the previous submission in 2014. This reported reduction in Rehabilitation Plans is due to the miscalculation of this number in the 2014 Supporting Statement. As a result of this adjustment in the total number of Rehabilitation Plans, burden hours have decreased 338 hours, from the previous submission of 2,295 to 1,957.

Annual Cost to Federal Government: $485,809

Does this IC contain surveys, censuses, or employ statistical methods? No

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination. Yes

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination. Yes

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? No

Agency Contact: Cheryl Jordan 202 693-0289 jordan.cheryl@dol.gov

Something went wrong when downloading this file. If you have any questions, please send an email to risc@gsa.gov.