Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
MINER'S CLAIM FOR BENEFITS UNDER THE BLACK LUNG ACT, EMPLOYMENT HISTORY, AND MINER MEDICAL REIMBURSEMENT FORM Migrated 57500 20834 0 Form CM-911A,
Form & CM-915
Form CM-911,
Total burden requested under this ICR: 57500 20834 0  
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