View Information Collection Request (ICR) Package

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View ICR - OIRA Conclusion

OMB Control No: 1215-0052	ICR Reference No: 198904-1215-001
Status: Historical Active	Previous ICR Reference No: 198605-1215-006
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: 06/30/1989
	Date Received in OIRA: 04/06/1989
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	06/30/1992	06/30/1992	05/31/1989
Responses	54,500	0	57,500
Time Burden (Hours)	17,166	0	20,834
Cost Burden (Dollars)	0	0	0

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