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Agenda
Reg Review
ICR
Information Collection List
IC Title
Status
Responses
Hours
Dollars
Document Type
Form No.
Form Name
Application for Self-Insurance Under the black Lung Benefits Act
New
318
283
145
Form and Instruction
CM-2017A
Report of Claims Information
Form and Instruction
CM-2017B
Report of Claims Information
Form
CM-2017
Application or Renewal of Self-Insurance Authority
Instruction
Total burden requested under this ICR:
318
283
145
To view an IC, click on IC Title
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The .gov means it's official.
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