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View ICR - OIRA Conclusion

OMB Control No: 1240-0027	ICR Reference No: 201510-1240-003
Status: Historical Active	Previous ICR Reference No: 201306-1240-004
Agency/Subagency: DOL/OWCP	Agency Tracking No:
Title: Survivor's Form for Benefits Under the Black Lung Benefits Act
Type of Information Collection: No material or nonsubstantive change to a currently approved collection	Common Form ICR: No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 10/28/2015
	Date Received in OIRA: 10/26/2015
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	12/31/2016	12/31/2016	12/31/2016
Responses	1,100	0	1,100
Time Burden (Hours)	147	0	147
Cost Burden (Dollars)	441	0	441

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