Hazardous Conditions Complaints

Hazardous Conditions Complaints

OMB: 1219-0014

IC ID: 14363

Documents and Forms
Document Name
Document Type
Form and Instruction
Instruction
Instruction
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
Information Collection (IC) Details

View Information Collection (IC)

Hazardous Conditions Complaints
 
No Modified
 
Voluntary
 
30 CFR 43.7 30 CFR 43.4

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction None Hazardous Conditions Compliant (ENGLISH) 1219-0014 Screenshots Web Instrument.docx https://www.msha.gov/support-resources/forms-online-filing/2018/05/23/hazardous-condition-complaint Yes Yes Fillable Fileable
Instruction 1219-0014 Hazards Conditions Complaint MSHA Intro.pdf https://www.msha.gov/support-resources/forms-online-filing/2018/05/23/hazardous-condition-complaint Yes Yes Fillable Fileable
Form and Instruction None Hazardous Conditions Complaint (SPANISH) 1219-0014 Screen Shots Web Instrument SPANISH.docx https://www.msha.gov/support-resources/forms-online-filing/2018/05/23/hazardous-condition-complaint Yes Yes Fillable Fileable

Workforce Management Worker Safety

 

1,785 0
   
Individuals or Households
 
   96 %

  Approved 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 1,785 0 0 -191 0 1,976
Annual IC Time Burden (Hours) 357 0 0 -38 0 395
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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