Information Collection

Direct Observation: Continuous Miner Operator

IC 207520 under ICR 201509-0920-003 · OMB 0920-0981.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Direct Observation: Continuous Miner Operator	Form
Informed Consent Appendix K_Direct Observation Consent and Consent Script.docx	Form and Instruction
Direct Observation: Continuous Miner Operator Appendix C1_Direct Observation.docx	Form
Appendix O_Direct Observation_Protocol.doc Appendix O_Direct Observation_Protocol	IC Document

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Removed

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	Direct Observation: Continuous Miner Operator	Appendix C1_Direct Observation.docx		Yes	No	Paper Only
Form and Instruction	None	Informed Consent	Appendix K_Direct Observation Consent and Consent Script.docx		Yes	No	Paper Only

Line of Business: Workforce Management

Subfunction: Worker Safety

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 10

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	-10	10
Annual IC Time Burden (Hours)	-40	40
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Appendix O_Direct Observation_Protocol	Appendix O_Direct Observation_Protocol.doc	06/14/2013

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