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View ICR - OIRA Conclusion

OMB Control No: 1240-0006	ICR Reference No: 202303-1240-003
Status: Active	Previous ICR Reference No: 202302-1240-004
Agency/Subagency: DOL/OWCP	Agency Tracking No:
Title: Claim for Reimbursement of Benefit Payments and Claims Expense Under the War Hazards Compensation Act
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 with change	Conclusion Date: 06/02/2023
	Date Received in OIRA: 05/01/2023
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	06/30/2026	36 Months From Approved	07/31/2023
Responses	1,264	0	812
Time Burden (Hours)	632	0	406
Cost Burden (Dollars)	2,427	0	7,742

ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to Adjustment in Estimate
Annual Number of Responses	1,264	812	452
Annual Time Burden (Hours)	632	406	226
Annual Cost Burden (Dollars)	2,427	7,742	-5,315

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 was an increase of 452 responses (812 to 1,264). Due to the increase in the number of beneficiaries, the previously approved number of burden hours (406), is now (632), an increase of 226. The cost decrease is due to an erroneous number being reported in the last iteration instead of $1,177.00, the previous cost to respondents.

Annual Cost to Federal Government: $28,946

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. No

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. No

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: Marcus Sharpless 202 693-0998 sharpless.marcus@dol.gov

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