ICR Documents

Supporting Statement A Document Date Uploaded 1240-0038_Supporting Statement_DEIA 9.12.23_MN.docx 01/30/2024 Supporting Statement B Document Date Uploaded Supplementary Documents Title Document Document Type Date Uploaded 20 CFR 725.304 20CFR725.304 - Forms and initial processing.pdf Supplementary Document 08/08/2014 DOL/OWCP-2 System of Record Notice.pdf Supplementary Document 01/08/2018 20 CFR 725.404(a) 725.404.docx Supplementary Document 04/10/2018 MINER’S CLAIM for BENEFITS UNDER THE BLACK LUNG BENEFITS ACT CM-911 AND EMPLOYMENT HISTORY CM-911a Justification CM-911 & CM-911a.docx Justification for No Material/Nonsubstantive Change 01/30/2024 Miner's Claim For Benefits Under The Black Lung Benefits Act CM-911 and Employment History CM-911a Justification CM-911 & CM-911a Translated in 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