Information Collection

Mine Escape participants: Post-Training Questionnaire

IC 207509 under ICR 201407-0920-006 · OMB 0920-0975.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Mine Escape participants: Post-Training Questionnaire	Form
Mine escape participants Post-training questionnaire Attachment C4.docx	Form

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Voluntary

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
Form	none	Mine escape participants Post-training questionnaire	Attachment C4.docx		No		Paper Only

Line of Business: Workforce Management

Subfunction: Worker Safety

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 120

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	120	60	60
Annual IC Time Burden (Hours)	6	3	3
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
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.