Information Collection

1) Comparability Of Current Work To Coal Mine Employment 2) Coal Mine Employment Affidavit 3) Affidavit Of Deceased Miner's Condition

IC 121981 under ICR 198403-1215-001 · OMB 1215-0056.

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Information Collection (IC) Details

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IC Title:	1) COMPARABILITY OF CURRENT WORK TO COAL MINE EMPLOYMENT 2) COAL MINE EMPLOYMENT AFFIDAVIT 3) AFFIDAVIT OF DECEASED MINER'S CONDITION	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-913,	No	No
Form	CM-918,	No	No
Form	CM-1093	No	No

Line of Business:

Subfunction:

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 22,500	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	22,500	-24,250	46,750
Annual IC Time Burden (Hours)	7,500	-6,000	13,500
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.