OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

Coal Miner Radiograph (CWHSP)

IC 197450 under ICR 202507-0920-012 · OMB 0920-0020.

Documents and Forms

Documents and forms in this information collection
Document NameDocument Type
Form CDC/NIOSH 2.8(E),
Chest Radiograph Classification Coal Miner Radiograph (CWHSP)		 Form
Form 0920-24IK
Chest Radiograph Classification Coal Miner Radiograph (CWHSP)		 Form
CDC/NIOSH 2.8(E), Chest Radiograph Classification
Attachment 11 Chest Rad Classification Form Form No. CDC NIOSH (M) 2.8.docx 		Form
0920-24IK Chest Radiograph Classification
Attachment 11_2.08_ChestRadiographClassificationForm.pdf 		Form
Attachment 10 .docx
Sample Letter (Results of Radiograph)		IC Document

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 2.8(E), Revised 01/2020 Yes Yes Fillable Fileable
Form 0920-24IK 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 4,788 0 0 0 0 4,788
Annual IC Time Burden (Hours) 1,197 0 0 0 0 1,197
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Documents for IC
table that charts IC Documents
Title Document Date Uploaded
Sample Letter (Results of Radiograph) 12/02/2021
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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