Information Collection

Mine Safety and Health State Assistance Grants

IC 219212 under ICR 201209-1225-001 · OMB 1225-0086.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1225-0086 can be found here:

Documents and Forms

Document Name Document Type
FY 16 Final FOA.PDF www.grants.gov Other-Funding Opportunity Announceme
State Grant FOA Justification PRA3 8-18-15 for Sept30.doc State Grant FOA Justification IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Mine Safety and Health State Assistance Grants	Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Funding Opportunity Announcement			FY 16 Final FOA.PDF	www.grants.gov	Yes	Yes	Fillable Fileable Signable

Line of Business: Workforce Management

Subfunction: Worker Safety

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 50	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 90 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	500	500
Annual IC Time Burden (Hours)	1,625	1,625
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
State Grant FOA Justification	State Grant FOA Justification PRA3 8-18-15 for Sept30.doc	12/08/2015

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