Claims Under the Radiation Exposure Compensation Act (RECA)

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1105-0052 can be found here:

Documents and Forms

Document Name Document Type
Form OMB Number 1105-00 Claims Under the Radiation Exposure Compensation Act (RECA) Form and Instruction
OMB Number 1105-00 RECA Downwinder RECA Downwinder_revised_091311.pdf www.usdoj.gov/civil/torts/const/reca/claimform.htm Form and Instruction
OMB Number 1105-00 RECA Onsite Participant RECA Onsite Participant_revised_091311.pdf www.usdoj.gov/civil/torts/const/reca/claimform.htm Form and Instruction
OMB Number 1105-00 RECA Uranium Mill RECA Uranium Mill_revised_091311.pdf www.usdoj.gov/civil/torts/const/reca/claimform.htm Form and Instruction
OMB Number 1105-00 RECA Uranium Mine RECA Uranium Mine_revised_091311.pdf www.usdoj.gov/civil/torts/const/reca/claimform.htm Form and Instruction
OMB Number 1105-00 RECA Uranium Ore RECA Uranium Ore_revised_091311.pdf www.usdoj.gov/civil/torts/const/reca/claimform.htm Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Claims Under the Radiation Exposure Compensation Act (RECA)	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	OMB Number 1105-0052	RECA Downwinder	RECA Downwinder_revised_091311.pdf	http://www.usdoj.gov/civil/torts/const/reca/claimform.htm	Yes	No	Printable Only
Form and Instruction	OMB Number 1105-0052	RECA Onsite Participant	RECA Onsite Participant_revised_091311.pdf	http://www.usdoj.gov/civil/torts/const/reca/claimform.htm	Yes	No	Printable Only
Form and Instruction	OMB Number 1105-0052	RECA Uranium Mill	RECA Uranium Mill_revised_091311.pdf	http://www.usdoj.gov/civil/torts/const/reca/claimform.htm	Yes	No	Printable Only
Form and Instruction	OMB Number 1105-0052	RECA Uranium Mine	RECA Uranium Mine_revised_091311.pdf	http://www.usdoj.gov/civil/torts/const/reca/claimform.htm	Yes	No	Printable Only
Form and Instruction	OMB Number 1105-0052	RECA Uranium Ore	RECA Uranium Ore_revised_091311.pdf	http://www.usdoj.gov/civil/torts/const/reca/claimform.htm	Yes	No	Printable Only

Line of Business: Litigation and Judicial Activities

Subfunction: Resolution Facilitation

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 2,000	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	2,000	0	2,000
Annual IC Time Burden (Hours)	5,000	0	5,000
Annual IC Cost Burden (Dollars)	50,000	50,000	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.