View Information Collection (IC)

View Information Collection (IC)

Roentgenographic Interpretation (CM-933), Roentgenographic Quality Rereading (CM-933b), Medical History and Examination for Coal Mine Workers' Pneumoconiosis (CM-988), Report of....
No Modified
Required to Obtain or Retain Benefits
20 CFR 718.102-105

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form CM-933b Radiologic Quality Rereading 2014 CM-933b Final.pdf Yes No Fillable Printable
Form CM-933 Radiologic Interpretation 2014 CM-933 Final.pdf Yes No Fillable Printable
Form CM-1159 Report of Arterial Blood Gas Test 2014 cm-1159 Final.pdf Yes No Fillable Printable
Form CM-2907 Report of Ventilatory Study 2014 CM-2907 Final.pdf Yes No Fillable Printable
Form CM-988 Medical History and Examination 2014 cm-988 Final.pdf Yes No Fillable Printable

Income Security General Retirement and Disability

DOL/ESA-6, DOL/ESA-30  67 FR 16869

24,000 0
Private Sector Businesses or other for-profits
   0 %

  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 24,000 0 0 0 0 24,000
Annual IC Time Burden (Hours) 5,840 0 0 0 0 5,840
Annual IC Cost Burden (Dollars) 0 0 0 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.