Black Lung Medical Reports 20 Cfr Part 718

BLACK LUNG MEDICAL REPORTS 20 CFR PART 718

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1215-0090 can be found here:

Documents and Forms

Document Name Document Type

no available documents/forms check other ICs listed under this ICR

Information Collection (IC) Details

IC Title:	BLACK LUNG MEDICAL REPORTS 20 CFR PART 718	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Migrated

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Available Electronically?	Can Be Submitted Electronically?
Form	CM-907	No	No
Form	CM-933	No	No
Form	CM-933B	No	No
Form	CM988	No	No
Form	CM1159	No	No

Line of Business:

Subfunction:

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 202,000	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	202,000	98,250	-56,250	160,000
Annual IC Time Burden (Hours)	34,400	-13,100	7,500	40,000
Annual IC Cost Burden (Dollars)	0	0	0	0

Documents for IC

Title	Document	Date Uploaded

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.