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Coal Contractor Plan (CDC/NIOSH 2.18)
National Coal Workers' Health Surveillance Program (CWHSP)
OMB: 0920-0020
IC ID: 212093
OMB.report
HHS/CDC
OMB 0920-0020
ICR 202105-0920-011
IC 212093
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0020 can be found here:
2022-02-07 - Revision of a currently approved collection
2021-09-09 - Extension without change of a currently approved collection
Documents and Forms
Document Name
Document Type
Form 2.18
Coal Contractor Plan (CDC/NIOSH 2.18)
Form
2.18 Coal contractor plan
Attachment 4 Coal Contractor Plan 2.18.docx
Form
2.18 Coal contractor plan
Attachment 4 Coal Contractor Plan 2.18.docx
Form
2.18_Instructions_CDC_NIOSH_2.18_REV0120_ContractorPlan_Instructions_updated.docx
Instructions for 2.18 Form
IC Document
2.18_Instructions_CDC_NIOSH_2.18_REV0120_ContractorPlan_Instructions_updated.docx
Instructions for 2.18 Form
IC Document
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Coal Contractor Plan (CDC/NIOSH 2.18)
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Modified
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
2.18
Coal contractor plan
Attachment 4 Coal Contractor Plan 2.18.docx
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
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:
160
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
95 %
Requested
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
160
0
-415
0
0
575
Annual IC Time Burden (Hours)
80
0
-208
0
0
288
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
Instructions for 2.18 Form
2.18_Instructions_CDC_NIOSH_2.18_REV0120_ContractorPlan_Instructions_updated.docx
04/22/2021
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.