Application for Self-Insurance Under the Black Lung Benefits Act
ICR 202401-1240-005
OMB: 1240-0057
Federal Form Document
⚠️ Notice: This information collection may be outdated. More recent filings for OMB 1240-0057 can be found here:
Forms and Documents
Document Name | Status |
|---|---|
Supporting Statement A | 2024-01-30 |
Supporting Statement A | 2024-01-30 |
Justification for No Material/Nonsubstantive Change | 2024-01-30 |
Justification for No Material/Nonsubstantive Change | 2024-01-30 |
Supplementary Document | 2022-09-07 |
Supplementary Document | 2022-09-07 |
Supporting Statement 1240-0057 after comments.docxIC Document Collections
| IC ID | Document Title | Status | |
|---|---|---|---|
| 234819 | Modified |
Application for Self-Insurance Under the black Lung Benefits ActICR Details
© 2025 OMB.report | Privacy Policy