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Rehablitation Plan and Award
Rehabilitation Plan and Award
OMB: 1240-0045
IC ID: 13717
OMB.report
DOL/OWCP
OMB 1240-0045
ICR 201403-1240-003
IC 13717
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1240-0045 can be found here:
2023-12-08 - Extension without change of a currently approved collection
2020-12-01 - Revision of a currently approved collection
Documents and Forms
Document Name
Document Type
Form OWCP-16
Rehablitation Plan and Award
Form and Instruction
OWCP-16 Rehabilitation Plan and Award
OWCP-16.pdf
www.dol.gov/owcp/dfec/regs/compliance/OWCP-16.pdf
Form and Instruction
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Rehablitation Plan and Award
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Modified
Obligation to Respond:
Required to Obtain or Retain Benefits
CFR Citation:
20 CFR 10.518
20 CFR 702.507
20 CFR 10.519
20 CFR 702.506
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form and Instruction
OWCP-16
Rehabilitation Plan and Award
OWCP-16.pdf
http://www.dol.gov/owcp/dfec/regs/compliance/OWCP-16.pdf
Yes
No
Fillable Printable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Workforce Management
Subfunction:
Training and Employment
Privacy Act System of Records
Title:
DOL/GOVT-1(FECA);DOL/ESA-15(LHWCA)
FR Citation:
67 FR 16815
Number of Respondents:
4,590
Number of Respondents for Small Entity:
0
Affected Public:
Private Sector
Private Sector:
Businesses or other for-profits, Not-for-profit institutions
Percentage of Respondents Reporting Electronically:
0 %
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
4,590
0
0
-910
0
5,500
Annual IC Time Burden (Hours)
2,295
0
0
-455
0
2,750
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.