View Information Collection Request (ICR) Package

Please note that the OMB number and expiration date may not have been determined when this Information Collection Request and associated Information Collection forms were submitted to OMB. The approved OMB number and expiration date may be found by clicking on the Notice of Action link below.

View ICR - OIRA Conclusion

OMB Control No: 1215-0069	ICR Reference No: 198905-1215-003
Status: Historical Active	Previous ICR Reference No: 198904-1215-019
Agency/Subagency: DOL/ESA	Agency Tracking No:
Title: SURVIVOR'S CLAIM FOR BENEFITS UNDER THE BLACK LUNG BENEFITS ACT
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: 08/01/1989
	Date Received in OIRA: 05/04/1989
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	07/31/1992	07/31/1992	07/31/1989
Responses	1,500	0	2,350
Time Burden (Hours)	630	0	783
Cost Burden (Dollars)	0	0	0

Something went wrong when downloading this file. If you have any questions, please send an email to risc@gsa.gov.