View Information Collection Request (ICR) Package

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View ICR - OIRA Conclusion

OMB Control No: 1240-0035	ICR Reference No: 202003-1240-001
Status: Historical Active	Previous ICR Reference No: 201703-1240-002
Agency/Subagency: DOL/OWCP	Agency Tracking No:
Title: Description of Coal Mine Work and Other Employment
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: 10/26/2020
	Date Received in OIRA: 06/09/2020
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	10/31/2023	36 Months From Approved	10/31/2020
Responses	6,100	0	1,650
Time Burden (Hours)	3,050	0	1,100
Cost Burden (Dollars)	3,515	0	858

ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to Agency Discretion
Annual Number of Responses	6,100	1,650	4,450
Annual Time Burden (Hours)	3,050	1,100	1,950
Annual Cost Burden (Dollars)	3,515	858	2,657

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: The total burden hours to respondents increased from 1,100 to 3,050 due to increased use of this information collection. Form is now used in nearly every claim filed, whereas previously, it was not. Simultaneously, the respondent’s annual costs have increased.

Annual Cost to Federal Government: $67,070

Does this IC contain surveys, censuses, or employ statistical methods? No

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination. No

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination. Yes

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? No

Agency Contact: Debbie Thurston 202 693-0913 Thurston.Debra@dol.gov

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