ICR Documents

Supporting Statement A Document Date Uploaded SS 1240-0027 CM-912 2023_OCIO-Final.docx 01/30/2024 Supporting Statement B Document Date Uploaded Supplementary Documents Title Document Document Type Date Uploaded DOL/OWCP-2 System of Record Notice-DOL OWCP-2.pdf Supplementary Document 11/26/2019 CFR 725.304 CFR 725.304.pdf Supplementary Document 11/26/2019 725.212 - 725.225 725.212 to 725.225.docx Supplementary Document 03/03/2020 DOL/OWCP-9 DOL-OWCP-9.pdf Supplementary Document 03/03/2020 SURVIVOR’S FORM FOR BENEFITS UNDER THE BLACK LUNG BENEFITS ACT Justification CM-912.docx Justification for No Material/Nonsubstantive Change 01/30/2024 Survivor's Form for Benefits Under the Black Lung Benefits Act Justification CM-912 Translated to Spanish.docx Justification for No Material/Nonsubstantive Change 02/21/2024 Public Comments Author Name Comment Document Author Affiliation Sponsoring Org. Type Category Date of Comment Date Comment Received