Request for Information on
Earnings, Dual Benefits, Dependents, and Third Party
Settlements
Extension without change of a currently approved collection
No
Regular
09/25/2023
Requested
Previously Approved
36 Months From Approved
11/30/2023
33,372
37,056
11,013
12,228
15,198
15,030
Form CA-1032 is used to obtain
information from claimants receiving compensation for an extended
period of time. This information is necessary to ensure that
compensation being paid is correct.
US Code:
5 USC
8116 Name of Law: Federal Employees' Compensation Act
US Code: 5 USC
8132 Name of Law: Federal Employees' Compensation Act
US Code: 5 USC
8148 Name of Law: Federal Employees' Compensation Act
US Code: 5 USC
8110 Name of Law: Federal Employees' Compensation Act
US Code: 5 USC
8106 Name of Law: Federal Employees' Compensation Act
The previous approved number of
annual respondents, 37,056 is now 33,372 which represents a
decrease of 3,684. The previously approved number for burden hours
was 12,228 the requested number now is 11,013, a decrease of 1,215
hours.
$416,449
No
Yes
Yes
No
No
No
No
Marcus Sharpless 202 693-0998
sharpless.marcus@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.