Information Collection

Record Of Examination For Hazardous Conditions (30 Cfr 77.1713)

IC 168890 under ICR 198405-1219-003 · OMB 1219-0083.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1219-0083 can be found here:

Documents and Forms

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Information Collection (IC) Details

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IC Title:	RECORD OF EXAMINATION FOR HAZARDOUS CONDITIONS (30 CFR 77.1713)	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Migrated

Obligation to Respond: Mandatory

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	MSHA-233R				No	No

Line of Business:

Subfunction:

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 5,419	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	1,800,000	6,597	-157,437	1,950,840
Annual IC Time Burden (Hours)	2,700,000	-75,420	1,800,000	975,420
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.