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 52700 14533 0 Form CM-911A,
Form & CM-915
Form CM-911,
Total burden requested under this ICR: 52700 14533 0  
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