Information Collection

Cotton Dust (29 CFR 1910.1043)

IC 13968 under ICR 201607-1218-020 · OMB 1218-0061.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1218-0061 can be found here:

Documents and Forms

Document Name Document Type
Form 29 CFR 1910.1043 A Cotton Dust (29 CFR 1910.1043) Form
29 CFR 1910.1043 A Respiratory Questionnaire 1910.1043 Cotton Dust - App B-1.docx Form
29 CFR 1910.1043 A Respiratory Questionnaire for Non-Textile Workers for th 1910.1043 Cotton Dust - App B-2.docx Form
29 CFR 1910.1043 A Abbreviated Respiratory Questionnaire 1910.1043 Cotton Dust - App B-3.docx Form
Cotton Dust Appendix B-I.pdf CFR Mark-up - Cotton Dust Appendix B-I IC Document
Cotton Dust Appendix B-III.pdf CFR Mark-up - Cotton Dust Appendix B-III IC Document
Cotton Dust Appendix B-II.pdf CFR Mark-up - Cotton Dust Appendix B-II IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Cotton Dust (29 CFR 1910.1043)	Agency IC Tracking Number:	1218-0061(2016)

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 29 CFR 1910.1043

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	29 CFR 1910.1043 Appendix B-I	Respiratory Questionnaire	1910.1043 Cotton Dust - App B-1.docx	Yes	No	Printable Only
Form	29 CFR 1910.1043 Appendix B-II	Respiratory Questionnaire for Non-Textile Workers for the Cotton Industry	1910.1043 Cotton Dust - App B-2.docx	Yes	No	Printable Only
Form	29 CFR 1910.1043 Appendix B-III	Abbreviated Respiratory Questionnaire	1910.1043 Cotton Dust - App B-3.docx	Yes	No	Printable Only

Line of Business: Workforce Management

Subfunction: Worker Safety

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 11,786	Number of Respondents for Small Entity: 0

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

Percentage of Respondents Reporting Electronically: 0 %

	Requested	Previously Approved
Annual Number of Responses for this IC	58,992	58,992
Annual IC Time Burden (Hours)	21,549	21,549
Annual IC Cost Burden (Dollars)	2,896,328	2,896,328

Documents for IC

Title	Document	Date Uploaded
CFR Mark-up - Cotton Dust Appendix B-I	Cotton Dust Appendix B-I.pdf	08/08/2016
CFR Mark-up - Cotton Dust Appendix B-III	Cotton Dust Appendix B-III.pdf	08/08/2016
CFR Mark-up - Cotton Dust Appendix B-II	Cotton Dust Appendix B-II.pdf	08/09/2016

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