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Paper Survey for Soliciting Feedback for Division of Energy Employees Occupational Illness Compensation (DEEOIC)
Improving Customer Experience (OMB Circular A-11, Section 280 Implementation) for the Department of Labor (DOL)
OMB: 1225-0093
IC ID: 250452
OMB.report
DOL/DM
OMB 1225-0093
ICR 202202-1225-001
IC 250452
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1225-0093 can be found here:
2023-12-29 - Extension without change of a currently approved collection
2023-08-29 - No material or nonsubstantive change to a currently approved collection
Documents and Forms
Document Name
Document Type
Form 1
Paper Survey for Soliciting Feedback for Division of Energy Employees Occupational Illness Compensation (DEEOIC)
Form and Instruction
1 DEEOIC Phone Survey
DEEOIC Claimaint Survey v2.pdf
Form and Instruction
ICR A11 Section 280 Clearance - DEEOIC Paper Survey Development Letter Oct 2021.docx
Justification Document - DEEOIC Survey
IC Document
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Paper Survey for Soliciting Feedback for Division of Energy Employees Occupational Illness Compensation (DEEOIC)
Agency IC Tracking Number:
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
Form and Instruction
1
DEEOIC Phone Survey
DEEOIC Claimaint Survey v2.pdf
No
Paper Only
Federal Enterprise Architecture Business Reference Module
Line of Business:
Workforce Management
Subfunction:
Worker Safety
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 %
Requested
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
2,000
0
2,000
0
0
0
Annual IC Time Burden (Hours)
167
0
167
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
Justification Document - DEEOIC Survey
ICR A11 Section 280 Clearance - DEEOIC Paper Survey Development Letter Oct 2021.docx
11/22/2021
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.