Information Collection

Cotton Dust (29 CFR 1910.1043)

IC 13968 under ICR 201809-1218-002 · OMB 1218-0061.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1218-0061 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 29 CFR 1910.1043 ( Appendix B-!, Respiratory Questionnaire; Appendix B-II, Respiratory Questionnaire for Non-Textile Workers for the Cotton Industry; Appendix B-III, Abbreviated Respiratory Questionnaire Cotton Dust (29 CFR 1910.1043)	Form
29 CFR 1910.1043 ( Appendix B-!, Respiratory Questionnaire; Appendix B-II, SIP IV Final Rule - Cotton Dust Appendix B Public Burden Statement (03.27.19).docx	Form
20181022182008.pdf Appendix B mark-up 10-22-18	IC Document

IC Title:

Cotton Dust (29 CFR 1910.1043)

Agency IC Tracking Number:

1218-0061(2018)SIPIV

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 29 CFR 1910.1043

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	29 CFR 1910.1043 (Appendix B) (B-I, B-II, B-III)				Yes	No	Printable Only

Line of Business: Workforce Management

Subfunction: Worker Safety

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 5,474

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
	Approved	Previously Approved
Annual Number of Responses for this IC	25,712	25,712
Annual IC Time Burden (Hours)	9,532	9,532
Annual IC Cost Burden (Dollars)	1,340,992	1,340,992

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Appendix B mark-up 10-22-18		10/22/2018

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

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