View Information Collection Request (ICR) Package

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View ICR - OIRA Conclusion

OMB Control No: 1215-0052	ICR Reference No: 198605-1215-006
Status: Historical Active	Previous ICR Reference No: 198305-1215-001
Agency/Subagency: DOL/ESA	Agency Tracking No:
Title: MINER'S CLAIM FOR BENEFITS UNDER THE BLACK LUNG ACT, EMPLOYMENT HISTORY, AND MINER MEDICAL REIMBURSEMENT FORM
Type of Information Collection: Revision of a currently approved collection	Common Form ICR: No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 07/14/1986
	Date Received in OIRA: 05/29/1986
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	05/31/1989	05/31/1989	08/31/1986
Responses	57,500	0	172,000
Time Burden (Hours)	20,834	0	28,083
Cost Burden (Dollars)	0	0	0

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