Pattern of Violations

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Documents and Forms

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Information Collection (IC) Details

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IC Title:	Pattern of Violations	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 30 CFR 104.2(a)(8)

Information Collection Instruments:

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

Line of Business: Workforce Management

Subfunction: Worker Safety

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 44	Number of Respondents for Small Entity: 7

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

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	44	-56	100
Annual IC Time Burden (Hours)	5,984	-7,616	13,600
Annual IC Cost Burden (Dollars)	4,400	-5,600	10,000

Documents for IC

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