EE-30 (Transplant Authorization Request)

Division of Energy Employees Occupational Illnesses Compensation (DEEOIC) Authorization Request Forms

OMB: 1240-0060

IC ID: 243778

Information Collection (IC) Details

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EE-30 (Transplant Authorization Request)
 
No Modified
 
Mandatory
 
20 CFR 30.700 20 CFR 30.400(a)

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction EE-30 Transplant Authorization Request EE-30 Transplant Authorization Request.pdf https://owcpmed.dol.gov/ Yes Yes Fillable Fileable

Workforce Management Worker Safety

DOL/OWCP-11  81 FR 25765

20 0
   
Individuals or Households
 
   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 20 0 0 10 0 10
Annual IC Time Burden (Hours) 3 0 0 1 0 2
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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