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⚠️ Notice: This information collection may be referencing outdated material.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

Documents and forms in this information collection
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

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:

table that charts list of 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 %

table that charts list of burden
	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

table that charts IC Documents
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.