Operator Response to Schedule for Submission of Additional Evidence, and Operator Response to Notice of Claim

Coal Mine Operator Response to Schedule for Submission of Additional Evidence and Operator Response to Notice of Claim

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1240-0033 can be found here:

Documents and Forms

Document Name Document Type
Form CM-2970a Operator Response to Schedule for Submission of Additional Evidence, and Operator Response to Notice of Claim Form
CM-2970a OPERATOR RESPONSE TO NOTICE OF CLAIM Operator response to Notice of Claim Form CM-2970a.docx www.dol.gov/sites/dolgov/files/owcp/regs/compliance/cm-2970a.pdf Form
CM-2970a OPERATOR RESPONSE TO NOTICE OF CLAIM Operator response to Notice of Claim Form CM-2970a.docx www.dol.gov/sites/dolgov/files/owcp/regs/compliance/cm-2970a.pdf Form
CM-2970 Operator response to schedule for submission of addition Operator Response Form to SSAE Form CM-2970.docx www.dol.gov/sites/dolgov/files/owcp/regs/compliance/cm-2970a.pdf Form
CM-2970 Operator response to schedule for submission of addition Operator Response Form to SSAE Form CM-2970.docx www.dol.gov/sites/dolgov/files/owcp/regs/compliance/cm-2970a.pdf Form

Information Collection (IC) Details

IC Title:	Operator Response to Schedule for Submission of Additional Evidence, and Operator Response to Notice of Claim	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 20 CFR 725.412a 20 CFR 725.408(a)(2)

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	CM-2970a	OPERATOR RESPONSE TO NOTICE OF CLAIM	Operator response to Notice of Claim Form CM-2970a.docx	https://www.dol.gov/sites/dolgov/files/owcp/regs/compliance/cm-2970a.pdf	Yes	Yes	Fillable Printable
Form	CM-2970	Operator response to schedule for submission of additional evidence	Operator Response Form to SSAE Form CM-2970.docx	https://www.dol.gov/sites/dolgov/files/owcp/regs/compliance/cm-2970a.pdf	Yes	Yes	Fillable Printable

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records
Title: DOL/OWCP-2 and DOL/OWCP-9	FR Citation: 81 FR 25858

Number of Respondents: 5,294	Number of Respondents for Small Entity: 4,900

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

Percentage of Respondents Reporting Electronically: 70 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	5,294	-4,506	9,800
Annual IC Time Burden (Hours)	1,173	-869	2,042
Annual IC Cost Burden (Dollars)	1,096	-1,746	2,842

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.