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Black Lung Information Update
BLACK LUNG INFORMATION UPDATE
OMB: 1215-0087
IC ID: 168474
OMB.report
DOL/ESA
OMB 1215-0087
ICR 198206-1215-004
IC 168474
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1215-0087 can be found here:
1995-06-21 - Extension without change of a currently approved collection
1992-07-08 - Revision of a currently approved collection
Documents and Forms
Document Name
Document Type
no available documents/forms check other ICs listed under this ICR
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
BLACK LUNG INFORMATION UPDATE
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Migrated
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
CM-1088,
No
No
Form
1088A,
No
No
Form
1088B,
No
No
Form
1088C,
No
No
Form
& 1089
No
No
Federal Enterprise Architecture Business Reference Module
Line of Business:
Subfunction:
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
210,000
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
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
210,000
0
0
0
0
210,000
Annual IC Time Burden (Hours)
35,000
0
0
0
0
35,000
Annual IC Cost Burden (Dollars)
0
0
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.