Information Collection

Participant Demographic Information Collection Form

IC 260181 under ICR 202303-1219-007 · OMB 1219-0157.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form MSHA Form xxxx Participant Demographic Information Collection Form	Form and Instruction
MSHA Form xxxx Participate Demographic Information Collection Form Participant Demographic Information Collection Form 4-15-2024.docx	Form and Instruction
MSHA Form xxxx Participate Demographic Information Collection Form Participant Demographic Information Collection Form 5-21-2024.docx	Form and Instruction

IC Title:

Agency IC Tracking Number:

Is this a Common Form? Yes

IC Status: New

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
Form and Instruction	MSHA Form xxxx	Participate Demographic Information Collection Form	Participant Demographic Information Collection Form 5-21-2024.docx		Yes	No	Printable Only

Line of Business: Workforce Management

Subfunction: Training and Employment

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 150,000

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	150,000	150,000
Annual IC Time Burden (Hours)	7,500	7,500
Annual IC Cost Burden (Dollars)	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.