Proposed Collection; Comment Request, 23230-23231 [05-8844]
Download as PDF
<![CDATA[
23230
Federal Register / Vol. 70, No. 85 / Wednesday, May 4, 2005 / Notices
• Evaluate whether the proposed
collection of information is necessary
for the proper performance of the
functions of the agency, including
whether the information will have
particular utility;
• Evaluate the accuracy of the
agency’s estimate of the burden of the
proposed collection of information,
including the validity of the
methodology and assumptions used;
• Enhance the quality, utility, and
clarity of the information to be
collected; and
• Minimize the burden of the
collection of information on those who
are to respond, including through the
use of appropriate automated,
electronic, mechanical, or other
technological collection techniques or
other forms of information technology,
e.g., permitting electronic submission of
responses.
Agency: Employment Standards
Administration.
Type of Review: Extension of
currently approved collection.
Title: Rehabilitation Plan and Award.
OMB Number: 1215–0067.
Form Number: OWCP–16.
Frequency: On occasion.
Type of Response: Reporting.
Affected Public: Business and other
for-profit and Individuals or
households.
Number of Respondents: 7,000.
Annual Responses: 7,000.
Average Response Time: 30 minutes.
Total Annual Burden Hours: 3,500.
Total Annualized capital/startup
costs: $0.
Total Annual Costs (operating/
maintaining systems or purchasing
services): $0.
Description: The Office of Workers’
Compensation Programs (OWCP) is the
agency responsible for administration of
the Longshore and Harbor Workers’
Compensation Act; 33 U.S.C. 901 et
seq., and the Federal Employees’
Compensation Act, 5 U.S.C. 8101 et seq.
Both of these Acts authorize OWCP to
pay for approved vocational
rehabilitation services to eligible
workers with work-related disabilities.
OWCP must receive the signatures of
the worker and the rehabilitation
counselor to show that the worker
agrees to follow the proposed plan, and
that the proposed plan is appropriate.
The OWCP–16 is the standard format for
the collection of information needed to
approve proposed vocational
rehabilitation services. Form OWCP–16
serves to document the agreed upon
plan for rehabilitation services
submitted by the injured worker and
vocational rehabilitation counselor, the
costs involved, and OWCP’s award of
VerDate jul<14>2003
21:08 May 03, 2005
Jkt 205001
payment from funds provided for
rehabilitation. Form OWCP–16
summarizes the costs of the
rehabilitation plan to enable OWCP to
make a prompt decision on funding.
Agency: Employment Standards
Administration.
Type of Review: Extension of
currently approved collection.
Title: Report of Changes That May
Affect Your Black Lung Benefits.
OMB Number: 1215–0084.
Form Number: CM–929.
Frequency: Biannually.
Type of Response: Reporting.
Affected Public: Individuals or
households.
Number of Respondents: 51,000.
Annual Responses: 51,000.
Average Response Time: 5 to 8
minutes.
Total Annual Burden Hours: 4,505.
Total Annualized Capital/Startup
Costs: $0.
Total Annual Costs (operating/
maintaining systems or purchasing
services): $0.
Description: The Federal Mine Safety
and Health Act of 1977 as amended, 30
U.S.C. 941, and 20 CFR 725.533(e)
authorizes the Division of Coal Mine
Workers’ Compensation to pay
compensation to coal miner
beneficiaries. Once a miner or survivor
is found eligible for benefits, the
primary beneficiary is requested to
report certain changes that may affect
black lung benefits. The CM–929 is used
to help determine continuing eligibility
of primary beneficiaries receiving black
lung benefits from the Black Lung
Disability Trust Fund. The CM–929 is
completed by the beneficiary to report
factors that may affect his or her
benefits, including income, marital
status, receipt of state workers’
compensation and dependents’ status.
Agency: Employment Standards
Administration.
Type of Review: Extension of
currently approved collection.
Title: Housing Occupancy
Certificate—Migrant and Seasonal
Agricultural Worker Protection Act.
OMB Number: 1215–0158.
Form Number: WH–520.
Frequency: On occasion.
Type of Response: Reporting;
Recordkeeping; and Third party
disclosure.
Affected Public: Farms and Business
or other for-profit.
Number of Respondents: 300.
Annual Responses: 300.
Average Response Time: 3 minutes to
complete the form and 1 minute to post
a certification.
Total Annual Burden Hours: 20.
Total Annualized Capital/Startup
Costs: $0.
PO 00000
Frm 00143
Fmt 4703
Sfmt 4703
Total Annual Costs (operating/
maintaining systems or purchasing
services): $0.
Description: Section 203(b)(1) of the
Migrant and Seasonal Agricultural
Worker Protection Act, 29 U.S.C. 1801,
et seq., and Regulation 29 CFR
500.135(b) provide that any person who
owns or controls a facility or real
property to be used for housing migrant
agricultural workers shall not permit
such housing to be occupied by any
worker unless a copy of the certificate
of occupancy from the state, local, or
federal agency that conducted the
housing safety and health inspection is
posted at the site of the facility or real
property. Form WH–520 is both an
information gathering form and the
certificate of occupancy that the DOL
issues when it is the federal agency
conducting the safety and health
inspection.
Ira L. Mills,
Departmental Clearance Officer.
[FR Doc. 05–8847 Filed 5–3–05; 8:45 am]
BILLING CODE 4510–23–M
DEPARTMENT OF LABOR
Employment Standards Administration
Proposed Collection; Comment
Request
ACTION:
Notice.
SUMMARY: The Department of Labor, as
part of its continuing effort to reduce
paperwork and respondent burden,
conducts a preclearance consultation
program to provide the general public
and Federal agencies with an
opportunity to comment on proposed
and/or continuing collections of
information in accordance with the
Paperwork Reduction Act of 1995
(PRA95) (44 U.S.C. 3506(c)(2)(A)). This
program helps to ensure that requested
data can be provided in the desired
format, reporting burden (time and
financial resources) is minimized,
collection instruments are clearly
understood, and the impact of collection
requirements on respondents can be
properly assessed. Currently, the
Employment Standards Administration
is soliciting comments concerning the
proposed collection: Representative
Payee Report (CM–623), Representative
Payee Report, Short Form (CM–623S),
and Physician’s/Medical Officer’s
Statement (CM–787). A copy of the
proposed information collection request
can be obtained by contacting the office
listed below in the addresses section of
this Notice.
E:\FR\FM\04MYN1.SGM
04MYN1
Federal Register / Vol. 70, No. 85 / Wednesday, May 4, 2005 / Notices
Written comments must be
submitted to the office listed in the
addresses section below on or before
[insert date 60 days from the date of
publication].
DATES:
Ms. Hazel M. Bell, U.S.
Department of Labor, 200 Constitution
Ave., NW., Room S–3201, Washington,
DC 20210, telephone (202) 693–0418,
fax (202) 693–1451, e-mail
bell.hazel@dol.gov. Please use only one
method of transmission for comments
(mail, fax, or e-mail).
ADDRESSES:
SUPPLEMENTARY INFORMATION
I. Background
The Office of Workers’ Compensation
Programs administers the Federal Black
Lung Workers’ Compensation Program.
Under the Federal Mine Safety and
Health Act (30 U.S.C. 901) benefits due
a DOL black lung beneficiary may be
paid to a representative payee on behalf
of the beneficiary when the beneficiary
is unable to manage his/her benefits due
to incapability, incompetence, or
minority. The CM–623, Representative
Payee Report is used to collect
expenditure data regarding the
disbursement of the beneficiary’s
benefits by the representative payee to
assure that the beneficiary’s needs are
being met. The CM–623S,
Representative Payee Report, Short
Form is a shortened version of the CM–
623 that is used when the representative
payee is a family member. The CM–787,
Physician’s/Medical Officer’s Statement
is a form used by OWCP to gather
information from the beneficiary’s
physician about the capability of the
beneficiary to manage monthly benefits.
It is used by OWCP to determine if it is
in the beneficiary’s best interest to have
his/her benefits managed by another
party. The regulatory authority for
collecting this information is at 20 CFR
725.506, 510, 511, and 513. This
information collection is currently
approved for use through October 31,
2005.
II. Review Focus
The Department of Labor is
particularly interested in comments
which:
• Evaluate whether the proposed
collection of information is necessary
for the proper performance of the
functions of the agency, including
whether the information will have
practical utility;
• Evaluate the accuracy of the
agency’s estimate of the burden of the
proposed collection of information,
including the validity of the
methodology and assumptions used;
• Enhance the quality, utility and
clarity of the information to be
collected; and
• Minimize the burden of the
collection of information on those who
are to respond, including through the
use of appropriate automated,
electronic, mechanical, or other
Respondents/
responses
Forms
23231
technological collection techniques or
other forms of information technology,
e.g., permitting electronic submissions
of responses.
III. Current Actions
The Department of Labor seeks the
extension of approval to collect this
information in order to carry out its
responsibility to determine if a
beneficiary is capable and/or competent
to manage his/her black lung benefits,
and to ensure that the representative
payee is using the benefits to meet the
beneficiary’s needs.
Type of Review: Extension.
Agency: Employment Standards
Administration.
Title: Representative Payee Report
(CM–623), Representative Payee Report,
Short Form (CM–623S), and
Physician’s/Medical Officer’s Statement
(CM–787).
OMB Number: 1215–0173.
Agency Number: CM–623, CM–623S,
and CM–787.
Affected Public: Individuals or
households; Business or other for profit,
Not-for-profit institutions.
Total Respondents: 5,339.
Total Annual responses: 5,399.
Estimated Total Burden Hours: 5,430.
Frequency: On occasion.
Total Burden Cost (capital/startup):
$0.
Total Burden Cost (operating/
maintenance): $0.
Time per response
Burden hours
CM–623 ........................................................................
CM–623S ......................................................................
CM–787 ........................................................................
3,344
1,015
980
90 minutes ....................................................................
10 minutes ....................................................................
15 minutes ....................................................................
5,016
169
245
Total .......................................................................
5,339
.......................................................................................
5,430
Comments submitted in response to
this notice will be summarized and/or
included in the request for Office of
Management and Budget approval of the
information collection request; they will
also become a matter of public record.
DEPARTMENT OF LABOR
Dated: April 27, 2005.
Bruce Bohanon,
Chief, Branch of Management Review and
Internal Control, Division of Financial
Management, Office of Management,
Administration and Planning, Employment
Standards Administration.
[FR Doc. 05–8844 Filed 5–3–05; 8:45 am]
ACTION:
BILLING CODE 4510–CK–P
VerDate jul<14>2003
21:08 May 03, 2005
Jkt 205001
Employment Standards Administration
Proposed Collection; Comment
Request
Notice.
SUMMARY: The Department of Labor, as
part of its continuing effort to reduce
paperwork and respondent burden,
conducts a preclearance consultation
program to provide the general public
and Federal agencies with an
opportunity to comment on proposed
and/or continuing collections of
information in accordance with the
Paperwork Reduction Act of 1995
(PRA95) (44 U.S.C. 3506(c)(2)(A)). This
program helps to ensure that requested
PO 00000
Frm 00144
Fmt 4703
Sfmt 4703
data can be provided in the desired
format, reporting burden (time and
financial resources) is minimized,
collection instruments are clearly
understood, and the impact of collection
requirements on respondents can be
properly assessed. Currently, the
Employment Standards Administration
is soliciting comments concerning the
proposed collection: Employee
Polygraph Protection Act. A copy of the
proposed information collection request
can be obtained by contacting the office
listed below in the ADDRESSES section of
this Notice.
Written comments must be
submitted to the office listed in the
ADDRESSES section below on or before
July 5, 2005.
DATES:
E:\FR\FM\04MYN1.SGM
04MYN1
]]>Agencies
[Federal Register Volume 70, Number 85 (Wednesday, May 4, 2005)]
[Notices]
[Pages 23230-23231]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: 05-8844]
-----------------------------------------------------------------------
DEPARTMENT OF LABOR
Employment Standards Administration
Proposed Collection; Comment Request
ACTION: Notice.
-----------------------------------------------------------------------
SUMMARY: The Department of Labor, as part of its continuing effort to
reduce paperwork and respondent burden, conducts a preclearance
consultation program to provide the general public and Federal agencies
with an opportunity to comment on proposed and/or continuing
collections of information in accordance with the Paperwork Reduction
Act of 1995 (PRA95) (44 U.S.C. 3506(c)(2)(A)). This program helps to
ensure that requested data can be provided in the desired format,
reporting burden (time and financial resources) is minimized,
collection instruments are clearly understood, and the impact of
collection requirements on respondents can be properly assessed.
Currently, the Employment Standards Administration is soliciting
comments concerning the proposed collection: Representative Payee
Report (CM-623), Representative Payee Report, Short Form (CM-623S), and
Physician's/Medical Officer's Statement (CM-787). A copy of the
proposed information collection request can be obtained by contacting
the office listed below in the addresses section of this Notice.
[[Page 23231]]
DATES: Written comments must be submitted to the office listed in the
addresses section below on or before [insert date 60 days from the date
of publication].
ADDRESSES: Ms. Hazel M. Bell, U.S. Department of Labor, 200
Constitution Ave., NW., Room S-3201, Washington, DC 20210, telephone
(202) 693-0418, fax (202) 693-1451, e-mail bell.hazel@dol.gov. Please
use only one method of transmission for comments (mail, fax, or e-
mail).
SUPPLEMENTARY INFORMATION
I. Background
The Office of Workers' Compensation Programs administers the
Federal Black Lung Workers' Compensation Program. Under the Federal
Mine Safety and Health Act (30 U.S.C. 901) benefits due a DOL black
lung beneficiary may be paid to a representative payee on behalf of the
beneficiary when the beneficiary is unable to manage his/her benefits
due to incapability, incompetence, or minority. The CM-623,
Representative Payee Report is used to collect expenditure data
regarding the disbursement of the beneficiary's benefits by the
representative payee to assure that the beneficiary's needs are being
met. The CM-623S, Representative Payee Report, Short Form is a
shortened version of the CM-623 that is used when the representative
payee is a family member. The CM-787, Physician's/Medical Officer's
Statement is a form used by OWCP to gather information from the
beneficiary's physician about the capability of the beneficiary to
manage monthly benefits. It is used by OWCP to determine if it is in
the beneficiary's best interest to have his/her benefits managed by
another party. The regulatory authority for collecting this information
is at 20 CFR 725.506, 510, 511, and 513. This information collection is
currently approved for use through October 31, 2005.
II. Review Focus
The Department of Labor is particularly interested in comments
which:
Evaluate whether the proposed collection of information is
necessary for the proper performance of the functions of the agency,
including whether the information will have practical utility;
Evaluate the accuracy of the agency's estimate of the
burden of the proposed collection of information, including the
validity of the methodology and assumptions used;
Enhance the quality, utility and clarity of the
information to be collected; and
Minimize the burden of the collection of information on
those who are to respond, including through the use of appropriate
automated, electronic, mechanical, or other technological collection
techniques or other forms of information technology, e.g., permitting
electronic submissions of responses.
III. Current Actions
The Department of Labor seeks the extension of approval to collect
this information in order to carry out its responsibility to determine
if a beneficiary is capable and/or competent to manage his/her black
lung benefits, and to ensure that the representative payee is using the
benefits to meet the beneficiary's needs.
Type of Review: Extension.
Agency: Employment Standards Administration.
Title: Representative Payee Report (CM-623), Representative Payee
Report, Short Form (CM-623S), and Physician's/Medical Officer's
Statement (CM-787).
OMB Number: 1215-0173.
Agency Number: CM-623, CM-623S, and CM-787.
Affected Public: Individuals or households; Business or other for
profit, Not-for-profit institutions.
Total Respondents: 5,339.
Total Annual responses: 5,399.
Estimated Total Burden Hours: 5,430.
Frequency: On occasion.
Total Burden Cost (capital/startup): $0.
Total Burden Cost (operating/maintenance): $0.
----------------------------------------------------------------------------------------------------------------
Respondents/
Forms responses Time per response Burden hours
----------------------------------------------------------------------------------------------------------------
CM-623........................................ 3,344 90 minutes...................... 5,016
CM-623S....................................... 1,015 10 minutes...................... 169
CM-787........................................ 980 15 minutes...................... 245
-----------------
Total..................................... 5,339 ................................ 5,430
----------------------------------------------------------------------------------------------------------------
Comments submitted in response to this notice will be summarized
and/or included in the request for Office of Management and Budget
approval of the information collection request; they will also become a
matter of public record.
Dated: April 27, 2005.
Bruce Bohanon,
Chief, Branch of Management Review and Internal Control, Division of
Financial Management, Office of Management, Administration and
Planning, Employment Standards Administration.
[FR Doc. 05-8844 Filed 5-3-05; 8:45 am]
BILLING CODE 4510-CK-P
