Miner Identification Document (CDC/NIOSH 2.9)

National Coal Workers' Health Surveillance Program (CWHSP)

Documents and Forms

Document Name Document Type
Form CDC/NIOSH 2.9(E), Miner Identification Document (CDC/NIOSH 2.9) Form
CDC/NIOSH 2.9(E), Miner Identification Document Attachment 8 Miner Identification Doc Form No. CDC NIOSH (M) 2.9.docx Form
CDC/NIOSH 2.9(E), Miner Identification Document Attachment 8 Miner Identification Doc Form No. CDC NIOSH (M) 2.9.docx Form

Information Collection (IC) Details

IC Title:	Miner Identification Document (CDC/NIOSH 2.9)	Agency IC Tracking Number:	0920-0020

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	CDC/NIOSH 2.9(E), Revised 02/2019	Miner Identification Document	Attachment 8 Miner Identification Doc Form No. CDC NIOSH (M) 2.9.docx		Yes	No	Fillable Printable

Line of Business: Health

Subfunction: Illness Prevention

Privacy Act System of Records
Title: 09-20-0149-Morbidity Studies in Coal Mining, Metal and Non-Metal Mining and General Industry and 0920-0153- Mortality 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: 0 %

	Approved	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)	2,833	-2,021	4,854
Annual IC Cost Burden (Dollars)	0	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.