Rehabilitation Plan and Award

ICR 201003-1240-045

OMB: 1240-0045

Federal Form Document

Forms and Documents
Document
Name
Status
Form
Modified
Supporting Statement A
2008-03-17
Supplementary Document
2007-12-07
Supplementary Document
2007-12-07
Supplementary Document
2007-12-07
Supplementary Document
2007-12-07
IC Document Collections
IC ID
Document
Title
Status
13717 Modified
ICR Details
1240-0045 201003-1240-045
Historical Active 200504-1215-001
DOL/OWCP
Rehabilitation Plan and Award
Extension without change of a currently approved collection   No
Regular
Approved without change 03/12/2010
Retrieve Notice of Action (NOA) 03/12/2010
  Inventory as of this Action Requested Previously Approved
05/31/2011 36 Months From Approved
7,000 0 7,000
3,500 0 3,500
0 0 0

Form OWCP-16 is used by vocational rehabilitation counselors to submit an agreed upon rehabilitation plan to OWCP for approval, and documents OWCP's award of payment for any approved services.

US Code: 33 USC 901 et seq Name of Law: Longshore and Harbor Workers' Compensatinon Act (LHWCA)
   US Code: 5 USC 8101 et seq. Name of Law: Federal Employees' Compensation Act (FECA)
  
None

Not associated with rulemaking

  73 FR 2946 01/16/2008
73 FR 22432 04/25/2008
No

1
IC Title Form No. Form Name
Rehablitation Plan and Award OWCP-16, OWCP-16 Rehabilitation Plan and Award ,   Rehabilitation Plan and Award

  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 7,000 7,000 0 0 0 0
Annual Time Burden (Hours) 3,500 3,500 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No

$309,142
No
No
Uncollected
Uncollected
Uncollected
Uncollected
Shirley Jarman 202 693-5786 jarman.shirley@dol.gov

  No

On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
 
 
 
 
 
 
 
    (i) Why the information is being collected;
    (ii) Use of information;
    (iii) Burden estimate;
    (iv) Nature of response (voluntary, required for a benefit, or mandatory);
    (v) Nature and extent of confidentiality; and
    (vi) Need to display currently valid OMB control number;
 
 
 
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
04/25/2008


© 2024 OMB.report | Privacy Policy