Independent Contractor Registration Request

Independent Contractor Registration and Identification

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1219-0040 can be found here:

Documents and Forms

Document Name Document Type
Form 7000-52 Independent Contractor Registration Request Form and Instruction
7000-52 Contractor Identification (ID) Request form_7000-52_screen_print[1].doc www.msha.gov/forms/elawsforms/7000-52.htm Form and Instruction

Information Collection (IC) Details

IC Title:	Independent Contractor Registration Request	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation: 30 CFR 45.3

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	7000-52	Contractor Identification (ID) Request	form_7000-52_screen_print[1].doc	http://www.msha.gov/forms/elawsforms/7000-52.htm	Yes	Yes	Fillable Fileable

Line of Business: Workforce Management

Subfunction: Worker Safety

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 2,788	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 40 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	2,788	-97,877	100,665
Annual IC Time Burden (Hours)	336	-13,060	13,396
Annual IC Cost Burden (Dollars)	520	-183,480	184,000

Documents for IC

Title	Document	Date Uploaded
No associated records found

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