Information Collection

Coal Miner Radiograph (CWHSP)

IC 197450 under ICR 202105-0920-011 · OMB 0920-0020.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0020 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Attachment 9 Sample letter- participation.docx	Instruction
Attachment 9 Sample letter- participation.docx	Instruction
Attachment 10 Sample results letter.docx	Instruction
Attachment 10 Sample results letter.docx	Instruction

IC Title:

Coal Miner Radiograph (CWHSP)

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
Instruction			Attachment 9 Sample letter- participation.docx		Yes	Yes	Fillable Fileable
Instruction			Attachment 10 Sample results letter.docx		Yes	Yes	Fillable Fileable

Line of Business: Workforce Management

Subfunction: Worker Safety

Privacy Act System of Records

Title: Morbidity Studies in Coal Mining, Metal and Non-metal Mining and General Industry

FR Citation: 51 FR 42476

Number of Respondents: 8,500

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 95 %

table that charts list of burden
	Requested	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	8,500	-6,060	14,560
Annual IC Time Burden (Hours)	2,125	-1,515	3,640
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.