Information Collection

Roof Bolter Questionnaire

IC 207525 under ICR 201509-0920-003 · OMB 0920-0981.

Documents and Forms

Document Name Document Type
Roof Bolter Questionnaire Form and Instruction
Roof Bolter Questionnaire Appendix I_Roof bolter Questionnaire pre and post.doc Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Roof Bolter Questionnaire	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Unchanged

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	None	Roof Bolter Questionnaire	Appendix I_Roof bolter Questionnaire pre and post.doc		Yes	No	Paper Only

Line of Business: Workforce Management

Subfunction: Worker Safety

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 30	Number of Respondents for Small Entity: 0

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

Percentage of Respondents Reporting Electronically: 0 %

	Requested	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	60	60
Annual IC Time Burden (Hours)	15	15
Annual IC Cost Burden (Dollars)	0	0

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.