Information Collection

Black Lung Medical Reports 20 Cfr Part 718

IC 122131 under ICR 198305-1215-002 · OMB 1215-0090.

⚠️ Notice: This information collection may be referencing outdated material.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

Documents and Forms

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Information Collection (IC) Details

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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: 55,000	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	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	55,000	-147,000	202,000
Annual IC Time Burden (Hours)	11,001	-23,399	34,400
Annual IC Cost Burden (Dollars)	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.