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OMB Control No: 1910-5203	ICR Reference No: 202606-1910-001
Status: Received in OIRA	Previous ICR Reference No: 202301-1910-001
Agency/Subagency: DOE/DOEOA	Agency Tracking No: Stephanie Noell
Title: Contractor Safety
Type of Information Collection: No material or nonsubstantive change to a currently approved collection	Common Form ICR: No
Type of Review Request: Regular	Date Submitted to OIRA: 07/16/2026

	Requested	Previously Approved
Expiration Date	07/31/2027	07/31/2027
Responses	190	190
Time Burden (Hours)	50	50
Cost Burden (Dollars)	2,018	2,018

Number of Information Collection (IC) in this ICR: 1

IC Title	Form No.	Form Name
Contractor Safety	BPA F 5480.28e, BPA F 6410.15e, BPA F 6410.42e, BPA F 6410.18e	, , ,

ICR Summary of Burden

	Total Request	Previously Approved
Annual Number of Responses	190	190
Annual Time Burden (Hours)	50	50
Annual Cost Burden (Dollars)	2,018	2,018

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: This is a new collection.

Annual Cost to Federal Government: $7,881

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: Yohanna Freeman 301 903-1151 yohanna.freeman@hq.doe.gov

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