Information Collection

Record Of Results Of Examinations Of Self-rescuers (30 Cfr 75.1714-3)

IC 123162 under ICR 199103-1219-002 · OMB 1219-0044.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1219-0044 can be found here:

Documents and Forms

Document Name Document Type

No indexed documents/forms are available for this IC yet. A refresh has been queued.

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	RECORD OF RESULTS OF EXAMINATIONS OF SELF-RESCUERS (30 CFR 75.1714-3)	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Migrated

Obligation to Respond: Mandatory

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability

Line of Business:

Subfunction:

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 9,312	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	9,312	0	0	9,312
Annual IC Time Burden (Hours)	565	-6,088	-3,218	9,871
Annual IC Cost Burden (Dollars)	0	0	0	0

Documents for IC

Title	Document	Date Uploaded

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.