Information Collection

Black Lung Clinics Program Database

IC 6545 under ICR 200709-0915-001 · OMB 0915-0292.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0915-0292 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form BLCP 2007 Black Lung Clinics Program Database	Form and Instruction
BLCP 2007 BLCP 2007 0292 Manual 07.doc	Form and Instruction
BLCP 2008 2009 BLCP 2008 2009 0292 BLCP Manual 08 09.doc	Form and Instruction
0292 ATS spirometry.pdf BLCP Spirometry guidelines	IC Document
0292 ATS guidelines.pdf BLCP ATS standards	IC Document

IC Title:

Black Lung Clinics Program Database

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 42 CFR 55a (To search for a specific CFR, visit the Code of Federal Regulations.)

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	BLCP 2007	BLCP 2007	0292 Manual 07.doc		Yes	Yes	Fillable Fileable
Form and Instruction	BLCP 2008 2009	BLCP 2008 2009	0292 BLCP Manual 08 09.doc		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 15

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	15	0	15
Annual IC Time Burden (Hours)	300	150	150
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
BLCP Spirometry guidelines	0292 ATS spirometry.pdf	09/06/2007
BLCP ATS standards	0292 ATS guidelines.pdf	09/06/2007

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