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Contractor Survey-COP Nurse
Contractor Surveys under the Federal EmployeesÂ’ Compensation Act
OMB: 1240-0052
IC ID: 192948
OMB.report
DOL/OWCP
OMB 1240-0052
ICR 201005-1240-004
IC 192948
( )
Documents and Forms
Document Name
Document Type
contractor survey-cop nurse.pdf
Other-survey
revised COP Nurse Letter revised sep24.doc
Instruction
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Contractor Survey-COP Nurse
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
New
Obligation to Respond:
Voluntary
CFR Citation:
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Other-survey
contractor survey-cop nurse.pdf
No
Paper Only
Instruction
revised COP Nurse Letter revised sep24.doc
No
Paper Only
Federal Enterprise Architecture Business Reference Module
Line of Business:
Income Security
Subfunction:
General Retirement and Disability
Privacy Act System of Records
Title:
DOL/GOVT-1
FR Citation:
67 FR 16826
Number of Respondents:
132
Number of Respondents for Small Entity:
0
Affected Public:
Private Sector
Private Sector:
Businesses or other for-profits
Percentage of Respondents Reporting Electronically:
100 %
Approved
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
132
0
132
0
0
0
Annual IC Time Burden (Hours)
22
0
22
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
No associated records found
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.