OMB.report

Federal forms, ICRs, and supporting documents

OMB control number

Claim adjudication process for alleged presence of pneumoconiosis

OMB 1215-0090 · DOL/ESA.

OMB 1215-0090

Latest Forms, Documents, and Supporting Material

Document Name
Form CM-988 Roentgenographic Interpretation (CM-933), Roentgenographic Quality Rereading (CM-933b), Medical History and Examination for Coal Mine Workers' Pneumoconiosis (CM-988), Report of.... Form
1215-0090 Supporting Statement.doc Supporting Statement A
DOL Privacy Act systems ESA-30.pdf Supplementary Document
DOL Privacy Act systems ESA-6.pdf Supplementary Document
cm-988.pdf Supplementary Document
CM-1159 May 2008 with 50.doc Supplementary Document
cm-2907.pdf Supplementary Document
CM-933 Rev June 2008.pdf Supplementary Document
CM-933b 02-2008.pdf Supplementary Document
Roentgenographic Interpretation (CM-933), Roentgenographic Quality Rereading (CM-933b), Medical History and Examination for Coal Mine Workers' Pneumoconiosis (CM-988), Report of.... Form

All Historical Document Collections

200802-1215-002 Approved with change	Extension without change of a currently approved collection	2008-04-25
200502-1215-003 Approved without change	Revision of a currently approved collection	2005-02-04
200203-1215-001 Approved without change	Revision of a currently approved collection	2002-03-29
200201-1215-001 Withdrawn and continue	Revision of a currently approved collection	2002-01-24
199903-1215-001 Approved without change	Extension without change of a currently approved collection	1999-03-19
199601-1215-001 Approved without change	Extension without change of a currently approved collection	1996-01-26
199212-1215-002 Approved without change	Revision of a currently approved collection	1992-12-03
198911-1215-001 Approved without change	Revision of a currently approved collection	1989-11-13
198702-1215-006 Approved without change	Revision of a currently approved collection	1987-02-25
198605-1215-007 Approved without change	Revision of a currently approved collection	1986-05-29
198305-1215-002 Approved without change	Revision of a currently approved collection	1983-05-03
198106-1215-001 Approved without change	Revision of a currently approved collection	1981-06-20
198005-1215-004 Approved without change	New collection (Request for a new OMB Control Number)	1980-05-12