Agency Information Collection Activities; Proposed Collection, Comments Requested; USMS Medical Forms, 39324-39325 [2013-15607]

Download as PDF 39324 Federal Register / Vol. 78, No. 126 / Monday, July 1, 2013 / Notices By order of the Commission. Lisa R. Barton, Acting Secretary to the Commission. [FR Doc. 2013–15556 Filed 6–28–13; 8:45 am] BILLING CODE 7020–02–P DEPARTMENT OF JUSTICE [OMB Number 1105–NEW] Agency Information Collection Activities; Proposed Collection, Comments Requested; USMS Medical Forms mstockstill on DSK4VPTVN1PROD with NOTICES ACTION: 30-day Notice. The Department of Justice, U.S. Marshals Service will be submitting the following information collection request to the Office of Management and Budget (OMB) for review and clearance in accordance with established review procedures of the Paperwork Reduction Act of 1995. The proposed information collection is published to obtain comments from the public and affected agencies. This proposed information collection was previously published in the Federal Register Volume 78, Number 72, pages 22294–22295, on April 15, 2013, allowing for a 60 day comment period. The purpose of this notice is to allow for an additional 30 days for public comments until July 31, 2013. This process is conducted in accordance with 5 CFR 1320.10. All comments and suggestions, or questions regarding additional information, to include obtaining a copy of the proposed information collection instrument with instructions, should be directed to Nicole Feuerstein, U.S. Marshals Service, CS–3, 10th Fl., 2604 Jefferson Davis Hwy, Alexandria, VA 22301. Written comments and suggestions from the public and affected agencies concerning the proposed collection of information are encouraged. Comments should address one or more of the following four points: 1. 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; 2. 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; 3. Enhance the quality, utility, and clarity of the information to be collected; and 4. Minimize the burden of the collection of information on those who VerDate Mar<15>2010 21:38 Jun 28, 2013 Jkt 229001 are to respond, including the use of automated, electronic, mechanical, or other technological collection techniques of other forms of information technology, e.g., permitting electronic submission of responses. Overview of this information collection: 1. Type of information collection: New collection. 2. The title of the form/collection: USMS Medical Forms. 3. The agency form number, if any, and the applicable component of the department sponsoring the collection: Sponsored by the U.S. Marshals Service. Form Numbers: —USM–522A Physician Evaluation Report for USMS Operational Employees —USM–522P Physician Evaluation Report for USMS Operational Employees—Pregnancy Only —USM–600 Physical Requirements of USMS District Security Officers — CSO–012 Request to Reevaluate Court Security Officer’s Medical Qualification 4. Affected public who will be asked or required to respond, as well as a brief abstract: —USM–522A Physician Evaluation Report for USMS Operational Employees Æ Affected public: Private sector (Physicians) Æ Brief abstract: This form is to be used by operational law enforcement employees who are restricted from full performance of their duties for longer than 80 consecutive hours due to injury or illness; or by prospective operational employees who are impacted by medical issues prior to completing the Training Academy. The primary use of this information will be to determine the nature of a medical or physical condition that may affect safe and efficient performance of the work described in the employee’s position description. —USM–522P Physician Evaluation Report for USMS Operational Employees —(Pregnancy Only) Æ Affected public: Private sector (Physicians) Æ Brief abstract: This form is to be used by operational employees who are temporarily restricted from performing all of their duties due to pregnancy. In accordance with USMS Policy Directive 3.5, after a physician has confirmed the pregnancy, or no later than the completion of the first trimester of PO 00000 Frm 00074 Fmt 4703 Sfmt 4703 pregnancy (the end of the 13th week), the operational employee is responsible for securing a completed Form USM–522P, or equivalent, from her physician. The primary use of this information will be to determine the nature of a medical or physical condition that may affect safe and efficient performance of the work described in the employee’s position description. —USM–600 Physical Requirements of USMS District Security Officers Æ Affected public: Private sector (Physicians) Æ Brief abstract: It is the policy of the USMS to ensure a law enforcement work force that is medically able to safely perform the required job functions. Annual completion of Form USM–600 is required to ensure that all applicant and incumbent District Security Officers meet the medical standards as outlined in the Statement of Work and are medically qualified to perform all District Security Officer duties. —CSO–012 Request to Reevaluate Court Security Officer’s Medical Qualification Æ Affected public: Private sector (Physicians) Æ Brief abstract: Use of this form is required when a Court Security Officer (CSO) is returning to perform security services after recovering from an injury, illness, outpatient or inpatient surgery/ procedure (including such procedures as LASIK), hospitalization or emergency room visits, or extended medical reasons. A Court Security Officer may not resume security services until the USMS Office of Court Services has provided written approval for the individual to resume performing under the applicable contract. Court Security Officers are contractors, not employees of USMS; therefore, Form USM–522A does not apply to CSOs. 5. An estimate of the total number of respondents and the amount of time estimated for an average respondent to respond: —USM–522A Physician Evaluation Report for USMS Operational Employees It is estimated that 100 respondents will complete a 20 minute form. —USM–522P Physician Evaluation Report for USMS Operational Employees (Pregnancy Only) It is estimated that 12 respondents will complete a 15 minute form. E:\FR\FM\01JYN1.SGM 01JYN1 Federal Register / Vol. 78, No. 126 / Monday, July 1, 2013 / Notices —USM–600 Physical Requirements of USMS District Security Officers It is estimated that 800 respondents will complete a 20 minute form. — CSO–012 Request to Reevaluate Court Security Officer’s Medical Qualification It is estimated that 300 respondents will complete a 30 minute form. 6. An estimate of the total public burden (in hours) associated with this collection: —USM–522A Physician Evaluation Report for USMS Operational Employees There are an estimated 33 annual total burden hours associated with this collection. —USM–522P Physician Evaluation Report for USMS Operational Employees (Pregnancy Only) There are an estimated 3 annual total burden hours associated with this collection. —USM–600 Physical Requirements of USMS District Security Officers There are an estimated 267 annual total burden hours associated with this collection. —CSO–012 Request to Reevaluate Court Security Officer’s Medical Qualification There are an estimated 150 annual total burden hours associated with this collection. Total Annual Time Burden (Hour): 453. If additional information is required contact: Jerri Murray, Department of Justice Clearance Officer, Justice Management Division, United States Department of Justice, Policy and Planning Staff, Two Constitution Square, 145 N Street NE., 1407B, Washington, DC 20530. Dated: June 25, 2013. Jerri Murray, Department Clearance Officer for PRA, United States Department of Justice. [FR Doc. 2013–15607 Filed 6–28–13; 8:45 am] BILLING CODE 4410–04–P DEPARTMENT OF JUSTICE mstockstill on DSK4VPTVN1PROD with NOTICES [OMB Number 1105–NEW] Agency Information Collection Activities: Proposed Collection; Comments Requested Claims of U.S. Nationals Referred to the Commission by the Department of State Pursuant to Section 4(A)(1)(C) of the International Claims Settlement Act of 1949, as Amended, 22 U.S.C. 1623(a)(1)(C) ACTION: 60-Day Notice. The Foreign Claims Settlement Commission (Commission), Department VerDate Mar<15>2010 21:38 Jun 28, 2013 Jkt 229001 of Justice, will be submitting the following information collection request to the Office of Management and Budget (OMB) for review and clearance in accordance with the procedures of the Paperwork Reduction Act of 1995. The proposed information collection is published to obtain comments from the public and affected agencies. Comments should be directed to OMB, Office of Information and Regulatory Affairs, Attention: Department of Justice Desk Officer, Washington, DC 20503. Comments are encouraged and will be accepted for 60 days until August 30, 2013. All comments and suggestions, or questions regarding additional information, including obtaining a copy of the proposed information collection instrument, should be directed to Jeremy LaFrancois, Foreign Claims Settlement Commission, Department of Justice, 600 E Street NW., Suite 6002, Washington DC 20579, or by facsimile (202) 616–6993. Written comments and suggestions from the public and affected agencies concerning the proposed collection of information are encouraged. Comments should address one or more of the following four points: —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 submission of responses. Overview of this information collection: (1) Type of information collection: New Collection. (2) The title of the form/collection: Statement of Claim for filing of Claims Referred to the Commission under Section 4(a)(1)(C) of the International Claims Settlement Act of 1949. (3) The agency form number, if any, and the applicable component of the department sponsoring the collection: Form Number: FCSC–1. Foreign Claims PO 00000 Frm 00075 Fmt 4703 Sfmt 4703 39325 Settlement Commission, Department of Justice. (4) Affected public who will be asked or required to respond, as well as a brief abstract: Primary: Individuals. Other: Corporations. Information will be used as a basis for the Commission to receive, examine, adjudicate and render final decisions with respect to claims for compensation of U.S. nationals, referred to the Commission by the Department of State pursuant to section 4(a)(1)(C) of the International Claims Settlement Act of 1949, as amended, 22 U.S.C. 1623(A)(1)(C). (5) An estimate of the total number of respondents and the amount of time estimated for an average respondent to respond/reply: It is estimated that 500 individual respondents will complete the application, and that the amount of time estimated for an average respondent to reply is approximately two hours each. (6) An estimate of the total public burden (in hours) associated with the collection: The estimated total annual public burden associated with this application is 1,000 hours. If additional information is required contact: Jerri Murray, Department Clearance Officer, United States Department of Justice, Justice Management Division, Policy and Planning Staff, Two Constitution Square, 145 N Street NE., Room 1407B, Washington, DC 20530. Dated: June 25, 2013. Jerri Murray, Department Clearance Officer for PRA, U.S. Department of Justice. [FR Doc. 2013–15567 Filed 6–28–13; 8:45 am] BILLING CODE 4410–BA–P DEPARTMENT OF JUSTICE [OMB Number 1122–NEW] Agency Information Collection Activities: Revision of a Currently Approved Collection; Certification of Compliance With the Statutory Eligibility Requirements of the Violence Against omen Act as Amended for Applicants to the STOP (Services* Training* Officers* Prosecutors) Violence Against Women Formula Grant Program ACTION: 60-Day Notice. The Department of Justice, Office on Violence Against Women (OVW) will be submitting the following information collection request to the Office of Management and Budget (OMB) for review and approval in accordance with the Paperwork Reduction Act of 1995. E:\FR\FM\01JYN1.SGM 01JYN1

Agencies

[Federal Register Volume 78, Number 126 (Monday, July 1, 2013)]
[Notices]
[Pages 39324-39325]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: 2013-15607]


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DEPARTMENT OF JUSTICE

[OMB Number 1105-NEW]


Agency Information Collection Activities; Proposed Collection, 
Comments Requested; USMS Medical Forms

ACTION: 30-day Notice.

-----------------------------------------------------------------------

    The Department of Justice, U.S. Marshals Service will be submitting 
the following information collection request to the Office of 
Management and Budget (OMB) for review and clearance in accordance with 
established review procedures of the Paperwork Reduction Act of 1995. 
The proposed information collection is published to obtain comments 
from the public and affected agencies. This proposed information 
collection was previously published in the Federal Register Volume 78, 
Number 72, pages 22294-22295, on April 15, 2013, allowing for a 60 day 
comment period.
    The purpose of this notice is to allow for an additional 30 days 
for public comments until July 31, 2013. This process is conducted in 
accordance with 5 CFR 1320.10.
    All comments and suggestions, or questions regarding additional 
information, to include obtaining a copy of the proposed information 
collection instrument with instructions, should be directed to Nicole 
Feuerstein, U.S. Marshals Service, CS-3, 10th Fl., 2604 Jefferson Davis 
Hwy, Alexandria, VA 22301.
    Written comments and suggestions from the public and affected 
agencies concerning the proposed collection of information are 
encouraged. Comments should address one or more of the following four 
points:
    1. 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;
    2. 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;
    3. Enhance the quality, utility, and clarity of the information to 
be collected; and
    4. Minimize the burden of the collection of information on those 
who are to respond, including the use of automated, electronic, 
mechanical, or other technological collection techniques of other forms 
of information technology, e.g., permitting electronic submission of 
responses.
    Overview of this information collection:
    1. Type of information collection: New collection.
    2. The title of the form/collection: USMS Medical Forms.
    3. The agency form number, if any, and the applicable component of 
the department sponsoring the collection: Sponsored by the U.S. 
Marshals Service.
    Form Numbers:

--USM-522A Physician Evaluation Report for USMS Operational Employees
--USM-522P Physician Evaluation Report for USMS Operational Employees--
Pregnancy Only
--USM-600 Physical Requirements of USMS District Security Officers
-- CSO-012 Request to Reevaluate Court Security Officer's Medical 
Qualification
    4. Affected public who will be asked or required to respond, as 
well as a brief abstract:

--USM-522A Physician Evaluation Report for USMS Operational Employees
    [cir] Affected public: Private sector (Physicians)
    [cir] Brief abstract: This form is to be used by operational law 
enforcement employees who are restricted from full performance of their 
duties for longer than 80 consecutive hours due to injury or illness; 
or by prospective operational employees who are impacted by medical 
issues prior to completing the Training Academy. The primary use of 
this information will be to determine the nature of a medical or 
physical condition that may affect safe and efficient performance of 
the work described in the employee's position description.
--USM-522P Physician Evaluation Report for USMS Operational Employees
--(Pregnancy Only)
    [cir] Affected public: Private sector (Physicians)
    [cir] Brief abstract: This form is to be used by operational 
employees who are temporarily restricted from performing all of their 
duties due to pregnancy. In accordance with USMS Policy Directive 3.5, 
after a physician has confirmed the pregnancy, or no later than the 
completion of the first trimester of pregnancy (the end of the 13th 
week), the operational employee is responsible for securing a completed 
Form USM-522P, or equivalent, from her physician. The primary use of 
this information will be to determine the nature of a medical or 
physical condition that may affect safe and efficient performance of 
the work described in the employee's position description.
--USM-600 Physical Requirements of USMS District Security Officers
    [cir] Affected public: Private sector (Physicians)
    [cir] Brief abstract: It is the policy of the USMS to ensure a law 
enforcement work force that is medically able to safely perform the 
required job functions. Annual completion of Form USM-600 is required 
to ensure that all applicant and incumbent District Security Officers 
meet the medical standards as outlined in the Statement of Work and are 
medically qualified to perform all District Security Officer duties.
--CSO-012 Request to Reevaluate Court Security Officer's Medical 
Qualification
    [cir] Affected public: Private sector (Physicians)
    [cir] Brief abstract: Use of this form is required when a Court 
Security Officer (CSO) is returning to perform security services after 
recovering from an injury, illness, outpatient or inpatient surgery/
procedure (including such procedures as LASIK), hospitalization or 
emergency room visits, or extended medical reasons. A Court Security 
Officer may not resume security services until the USMS Office of Court 
Services has provided written approval for the individual to resume 
performing under the applicable contract. Court Security Officers are 
contractors, not employees of USMS; therefore, Form USM-522A does not 
apply to CSOs.
    5. An estimate of the total number of respondents and the amount of 
time estimated for an average respondent to respond:

--USM-522A Physician Evaluation Report for USMS Operational Employees
    It is estimated that 100 respondents will complete a 20 minute 
form.
--USM-522P Physician Evaluation Report for USMS Operational Employees 
(Pregnancy Only)
    It is estimated that 12 respondents will complete a 15 minute form.

[[Page 39325]]

--USM-600 Physical Requirements of USMS District Security Officers
    It is estimated that 800 respondents will complete a 20 minute 
form.
-- CSO-012 Request to Reevaluate Court Security Officer's Medical 
Qualification
    It is estimated that 300 respondents will complete a 30 minute 
form.
    6. An estimate of the total public burden (in hours) associated 
with this collection:

--USM-522A Physician Evaluation Report for USMS Operational Employees
    There are an estimated 33 annual total burden hours associated with 
this collection.
--USM-522P Physician Evaluation Report for USMS Operational Employees 
(Pregnancy Only)
    There are an estimated 3 annual total burden hours associated with 
this collection.
--USM-600 Physical Requirements of USMS District Security Officers
    There are an estimated 267 annual total burden hours associated 
with this collection.
--CSO-012 Request to Reevaluate Court Security Officer's Medical 
Qualification
    There are an estimated 150 annual total burden hours associated 
with this collection.
    Total Annual Time Burden (Hour): 453.
    If additional information is required contact: Jerri Murray, 
Department of Justice Clearance Officer, Justice Management Division, 
United States Department of Justice, Policy and Planning Staff, Two 
Constitution Square, 145 N Street NE., 1407B, Washington, DC 20530.

    Dated: June 25, 2013.
Jerri Murray,
Department Clearance Officer for PRA, United States Department of 
Justice.
[FR Doc. 2013-15607 Filed 6-28-13; 8:45 am]
BILLING CODE 4410-04-P