OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

Miner Identification Document (CDC/NIOSH 2.9)

IC 183367 under ICR 202507-0920-012 · OMB 0920-0020.

Documents and Forms

Documents and forms in this information collection
Document NameDocument Type
Form CDC/NIOSH 2.9(E),
Miner Identification Document Miner Identification Document (CDC/NIOSH 2.9)		 Form
Form 0920-0020-24IK
Miner Identification Miner Identification Document (CDC/NIOSH 2.9)		 Form
CDC/NIOSH 2.9(E), Miner Identification Document
Attachment 8 Miner Identification Doc Form No. CDC NIOSH (M) 2.9.docx 		Form
0920-0020-24IK Miner Identification
Attachment 8_2.09_Miner-Identification-Form_REVISED 112024.pdf 		Form

Information Collection (IC) Details

View Information Collection (IC)

layout table

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 CDC/NIOSH 2.9(E), Revised 02/2019 Yes No Fillable Printable
Form 0920-0020-24IK Yes Yes Fillable Fileable

Federal Enterprise Architecture Business Reference Module


table that charts list of burden
  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 4,345 0 0 0 0 4,345
Annual IC Time Burden (Hours) 1,448 0 0 0 0 1,448
Annual IC Cost Burden (Dollars) 0 0 0 0 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.
Something went wrong when downloading this file. If you have any questions, please send an email to [email protected].