Information Collection

Independent Contractor Registration Request

IC 14399 under ICR 202410-1219-002 · OMB 1219-0040.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 7000-52 Independent Contractor Registration Request	Form and Instruction
Form 7000-52 Contractor Identification (ID) Request Independent Contractor Registration Request	Form and Instruction
7000-52 Intro Contractor ID Request.pdf www.msha.gov/support-resources/forms-online-filing/2015/04/15/contractor-id-request	Instruction
7000-52 Intro Contractor ID Request.pdf www.msha.gov/support-resources/forms-online-filing/2015/04/15/contractor-id-request	Instruction
7000-52 Contractor Identification (ID) Request 7000-52 Contractor ID Request.docx www.msha.gov/support-resources/forms-online-filing/2015/04/15/contractor-id-request	Form and Instruction
7000-52 Contractor Identification (ID) Request 7000-52 Contractor ID Request.docx www.msha.gov/support-resources/forms-online-filing/2015/04/15/contractor-id-request	Form and Instruction

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation: 30 CFR 45.3

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	7000-52			https://www.msha.gov/support-resources/forms-online-filing/2015/04/15/contractor-id-request	Yes	Yes	Fillable Fileable
Instruction				https://www.msha.gov/support-resources/forms-online-filing/2015/04/15/contractor-id-request	Yes	Yes	Fillable Fileable

Line of Business: Workforce Management

Subfunction: Worker Safety

Privacy Act System of Records

Title: DOL/MSHA-1

FR Citation: 81 FR 25766

Number of Respondents: 1,661

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 48 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	1,661	113	1,548
Annual IC Time Burden (Hours)	221	15	206
Annual IC Cost Burden (Dollars)	989	183	806

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.

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