Employer's Report Of Injury Or Occupational Illness Physicians Report On Impairment Of Vision

EMPLOYER'S REPORT OF INJURY OR OCCUPATIONAL ILLNESS PHYSICIANS REPORT ON IMPAIRMENT OF VISION

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1215-0031 can be found here:

Documents and Forms

Document Name Document Type

no available documents/forms check other ICs listed under this ICR

Information Collection (IC) Details

IC Title:	EMPLOYER'S REPORT OF INJURY OR OCCUPATIONAL ILLNESS PHYSICIANS REPORT ON IMPAIRMENT OF VISION	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Migrated

Obligation to Respond: Mandatory

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Available Electronically?	Can Be Submitted Electronically?
Form	20 CFR	No	No
Form	702.202	No	No
Form	407, LS-202	No	No
Form	202A, 202B	No	No
Form	205 & 210	No	No

Line of Business:

Subfunction:

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 1	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	200,820	-58,484	259,304
Annual IC Time Burden (Hours)	39,156	-52,987	92,143
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

Title	Document	Date Uploaded

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.