View Information Collection (IC)
View Information Collection (IC)

View Information Collection (IC)

Application for Self-Insurance Under the black Lung Benefits Act
 
No New
 
Mandatory
 
20 CFR 726.102 20 CFR 726.112

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction CM-2017A Yes Yes Fillable Printable
Form and Instruction CM-2017B Yes Yes Fillable Printable
Form CM-2017 Yes Yes Fillable Printable
Instruction Yes Yes Fillable Printable

Income Security General Retirement and Disability

DOL/OWCP-2  81 FR 25858

53 0
   
Private Sector Businesses or other for-profits
 
   33 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 318 0 318 0 0 0
Annual IC Time Burden (Hours) 283 0 283 0 0 0
Annual IC Cost Burden (Dollars) 145 0 145 0 0 0

Title Document Date Uploaded
No associated records found
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
Something went wrong when downloading this file. If you have any questions, please send an email to risc@gsa.gov.