Operator Controversion, Operator Response, Operator Response to Schedule for Submission of Additional Evidence, and Operator Response to Notice of Claim
ICR 201011-1240-002 · OMB 1240-0033 · Historical Active
⚠️ Notice: This information collection may be outdated. More recent filings for OMB 1240-0033 can be found here:
Operator Controversion, Operator Response, Operator Response to Schedule for Submission of Additional Evidence, and Operator Response to Notice of Claim
Extension without change of a currently approved collection
Forms CM-2790 & CM-2970a are used for claims filed after January 19, 2001 and indicate that the coal mine operator will submit additional evidence or respond to the notice of claim.
US Code:
30 USC 901
Name of Law: Black Lung Benefits Act
The agency has made no discretionary program changes. The estimated total number of forms has been adjusted upward by 20% because of an increase in claim filings. Furthermore, OWCP has revised the estimated mix of responses between the various forms. The estimated operating cost has risen slightly because of an increase in postage from 41¢ to 44¢ from the previous clearance.
On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
(i) Why the information is being collected;
(ii) Use of information;
(iii) Burden estimate;
(iv) Nature of response (voluntary, required for a benefit, or mandatory);
(v) Nature and extent of confidentiality; and
(vi) Need to display currently valid OMB control number;
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
Form CM-2970 Operator Controversion, Operator Response, Operator Response to Schedule for Submission of Additional Evidence, and Operator Response to Notice of Claim
Supporting Statement for 1240-0033 11-02-2010.doc
20CFR725.407-408.pdf
Operator Controversion, Operator Response, Operator Response to Schedule for Submission of Additional Evidence, and Operator Response to Notice of Claim