Information Collection

Mine escape participants: Post-simulation questionnaire - Field Test

IC 212372 under ICR 201407-0920-006 · OMB 0920-0975.

Documents and Forms

Document Name Document Type
Mine escape participants: Post-simulation questionnaire - Field Test Form
Mine escape participants post-simulation questionnaire - Attachment C3b.docx Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Mine escape participants: Post-simulation questionnaire - Field Test	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	none	Mine escape participants post-simulation questionnaire - field test	Attachment C3b.docx		No		Paper Only

Line of Business: Workforce Management

Subfunction: Worker Safety

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 60	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	60	60
Annual IC Time Burden (Hours)	3	3
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

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