Safety Program for Surface Mobile Equipment

Documents and Forms

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Information Collection (IC) Details

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IC Title:	Safety Program for Surface Mobile Equipment	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 30 CFR 57.23003(a)(1) 30 CFR 56.23003(a)(1) 30 CFR 77.2103(a)(1) 30 CFR 77.2103(a)(3) 30 CFR 56.23003(a)(3) 30 CFR 57.23003(a)(3) 30 CFR 56.23003(a)(2) 30 CFR 57.23003(a)(2) 30 CFR 71.2103(a)(2) 30 CFR 77.2104(b) 30 CFR 56.23003(b) 30 CFR 57.23003(b) 30 CFR 71.2103(b) 30 CFR 56.23004(b) 30 CFR 57.23004(b)

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability

Line of Business: Workforce Management

Subfunction: Worker Safety

Privacy Act System of Records
Title: Privacy Act Systems - DOL/MSHA-1	FR Citation: 81 FR 25769

Number of Respondents: 17,133	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 50 %

	Requested	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	17,133	17,133
Annual IC Time Burden (Hours)	314,222	314,222
Annual IC Cost Burden (Dollars)	17,049,439	17,049,439

Documents for IC

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Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.