30-Day Notice of Proposed Information Collection: Eligibility Questionnaire for HAVANA Act Payments, 70887 [2022-25253]
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Federal Register / Vol. 87, No. 223 / Monday, November 21, 2022 / Notices
• Form Number: DS–1648.
• Respondents: Foreign Government
Officials.
• Estimated Number of Respondents:
30,000.
• Estimated Number of Responses:
30,000.
• Average Time per Response: 15
Minutes.
• Total Estimated Burden Time: 7,500
hours.
• Frequency: On Occasion, when
applying for an A, G, or NATO Visa.
• Obligation to Respond: Required to
Obtain a Benefit.
We are soliciting public comments to
permit the Department to:
• Evaluate whether the proposed
information collection is necessary for
the proper functions of the Department.
• Evaluate the accuracy of our
estimate of the time and cost burden for
this proposed collection, including the
validity of the methodology and
assumptions used.
• Enhance the quality, utility, and
clarity of the information to be
collected.
• Minimize the reporting burden on
those who are to respond, including the
use of automated collection techniques
or other forms of information
technology.
Please note that comments submitted
in response to this Notice are public
record. Before including any detailed
personal information, you should be
aware that your comments as submitted,
including your personal information,
will be available for public review.
Abstract of Proposed Collection
The Department of State uses Form
DS–1648 to elicit information from
applicants who are applying for an A, G,
or NATO visa in the United States,
excluding applicants for an A–3, G–5 or
NATO–7 visa. Sections 101(a)(15)(A)
and (G) of the Immigration and
Nationality Act (INA), and Department
regulations at 22 CFR 41.25, 41.26, and
41.27, describe the criteria for these
nonimmigrant visa classifications.
lotter on DSK11XQN23PROD with NOTICES1
Methodology
The DS–1648 will be submitted
electronically to the Department. The
applicant will be instructed to print a
confirmation page containing a bar
coded record locator, which will be
scanned at the time of processing.
Robert L. Batchelder,
Acting Deputy Assistant Secretary, Bureau
of Consular Affairs, Department of State.
[FR Doc. 2022–25252 Filed 11–18–22; 8:45 am]
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DEPARTMENT OF STATE
[Public Notice: 11922]
30-Day Notice of Proposed Information
Collection: Eligibility Questionnaire for
HAVANA Act Payments
Notice of request for public
comment and submission to OMB of
proposed collection of information.
ACTION:
The Department of State has
submitted the information collection
described below to the Office of
Management and Budget (OMB) for
approval. In accordance with the
Paperwork Reduction Act of 1995 we
are requesting comments on this
collection from all interested
individuals and organizations. The
purpose of this Notice is to allow 30
days for public comment.
DATES: Submit comments up to
December 21, 2022.
ADDRESSES: Written comments and
recommendations for the proposed
information collection should be sent
within 30 days of publication of this
notice to www.reginfo.gov/public/do/
PRAMain. Find this particular
information collection by selecting
‘‘Currently under 30-day Review—Open
for Public Comments’’ or by using the
search function.
FOR FURTHER INFORMATION CONTACT:
Direct requests for additional
information regarding the collection
listed in this notice, including requests
for copies of the proposed collection
instrument and supporting documents,
to Susan Ware Harris, Senior Advisor,
Health Incidents Response Task Force,
who may be reached on 202–679–0127,
or at HIRTFStaffers@state.gov.
SUPPLEMENTARY INFORMATION:
• Title of Information Collection:
Eligibility Questionnaire for HAVANA
Act Payments.
• OMB Control Number: 1405–0250.
• Type of Request: Extension of a
Currently Approved Collection.
• Originating Office: S/HIRTF, Health
Incidents Response Task Force.
• Form Number: DS–4316.
• Respondents: Department of State
employees, former employees, and their
dependents, and the qualified
physicians whom they have consulted.
• Estimated Number of Respondents:
100.
• Estimated Number of Responses:
100.
• Average Time per Response: 30
minutes.
• Total Estimated Burden Time: 50
hours.
• Frequency: Once.
• Obligation to Respond: Required to
Obtain or Retain a Benefit.
SUMMARY:
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70887
We are soliciting public comments to
permit the Department to:
• Evaluate whether the proposed
information collection is necessary for
the proper functions of the Department.
• Evaluate the accuracy of our
estimate of the time and cost burden for
this proposed collection, including the
validity of the methodology and
assumptions used.
• Enhance the quality, utility, and
clarity of the information to be
collected.
• Minimize the reporting burden on
those who are to respond, including the
use of automated collection techniques
or other forms of information
technology.
Please note that comments submitted
in response to this Notice are public
record. Before including any detailed
personal information, you should be
aware that your comments as submitted,
including your personal information,
will be available for public review.
Abstract of Proposed Collection
On October 8, 2021, President Biden
signed the ‘‘Helping American Victims
Affected by Neurological Attacks’’
(HAVANA) Act of 2021 (Pub. L. 117–
46). In this statute, Congress authorized
federal agencies to make payments to
affected current employees, former
employees, and their dependents for
qualifying injuries to the brain. The DS–
4316 provides the required medical
substantiation for claims filed pursuant
to the HAVANA Act and the
Department’s recent rule, which was
effective August 15, 2022.
Methodology
An individual wishing to make a
claim under the HAVANA Act IFR will
fill out the ‘‘Patient Demographics’’
portion of the DS–4316, and provide it
to a U.S. board-certified physician
(currently certified by the American
Board of Psychiatry and Neurology
(ABPN) or the American Board of
Physical Medicine and Rehabilitation
(ABPMR)), who will complete the form
after examining the individual and
reviewing their records and will fax or
email the completed form to the
Department.
Kevin E. Bryant,
Deputy Director, Office of Directives
Management, U.S. Department of State.
[FR Doc. 2022–25253 Filed 11–18–22; 8:45 am]
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Agencies
[Federal Register Volume 87, Number 223 (Monday, November 21, 2022)]
[Notices]
[Page 70887]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2022-25253]
-----------------------------------------------------------------------
DEPARTMENT OF STATE
[Public Notice: 11922]
30-Day Notice of Proposed Information Collection: Eligibility
Questionnaire for HAVANA Act Payments
ACTION: Notice of request for public comment and submission to OMB of
proposed collection of information.
-----------------------------------------------------------------------
SUMMARY: The Department of State has submitted the information
collection described below to the Office of Management and Budget (OMB)
for approval. In accordance with the Paperwork Reduction Act of 1995 we
are requesting comments on this collection from all interested
individuals and organizations. The purpose of this Notice is to allow
30 days for public comment.
DATES: Submit comments up to December 21, 2022.
ADDRESSES: Written comments and recommendations for the proposed
information collection should be sent within 30 days of publication of
this notice to www.reginfo.gov/public/do/PRAMain. Find this particular
information collection by selecting ``Currently under 30-day Review--
Open for Public Comments'' or by using the search function.
FOR FURTHER INFORMATION CONTACT: Direct requests for additional
information regarding the collection listed in this notice, including
requests for copies of the proposed collection instrument and
supporting documents, to Susan Ware Harris, Senior Advisor, Health
Incidents Response Task Force, who may be reached on 202-679-0127, or
at [email protected].
SUPPLEMENTARY INFORMATION:
Title of Information Collection: Eligibility Questionnaire
for HAVANA Act Payments.
OMB Control Number: 1405-0250.
Type of Request: Extension of a Currently Approved
Collection.
Originating Office: S/HIRTF, Health Incidents Response
Task Force.
Form Number: DS-4316.
Respondents: Department of State employees, former
employees, and their dependents, and the qualified physicians whom they
have consulted.
Estimated Number of Respondents: 100.
Estimated Number of Responses: 100.
Average Time per Response: 30 minutes.
Total Estimated Burden Time: 50 hours.
Frequency: Once.
Obligation to Respond: Required to Obtain or Retain a
Benefit.
We are soliciting public comments to permit the Department to:
Evaluate whether the proposed information collection is
necessary for the proper functions of the Department.
Evaluate the accuracy of our estimate of the time and cost
burden for this proposed collection, including the validity of the
methodology and assumptions used.
Enhance the quality, utility, and clarity of the
information to be collected.
Minimize the reporting burden on those who are to respond,
including the use of automated collection techniques or other forms of
information technology.
Please note that comments submitted in response to this Notice are
public record. Before including any detailed personal information, you
should be aware that your comments as submitted, including your
personal information, will be available for public review.
Abstract of Proposed Collection
On October 8, 2021, President Biden signed the ``Helping American
Victims Affected by Neurological Attacks'' (HAVANA) Act of 2021 (Pub.
L. 117-46). In this statute, Congress authorized federal agencies to
make payments to affected current employees, former employees, and
their dependents for qualifying injuries to the brain. The DS-4316
provides the required medical substantiation for claims filed pursuant
to the HAVANA Act and the Department's recent rule, which was effective
August 15, 2022.
Methodology
An individual wishing to make a claim under the HAVANA Act IFR will
fill out the ``Patient Demographics'' portion of the DS-4316, and
provide it to a U.S. board-certified physician (currently certified by
the American Board of Psychiatry and Neurology (ABPN) or the American
Board of Physical Medicine and Rehabilitation (ABPMR)), who will
complete the form after examining the individual and reviewing their
records and will fax or email the completed form to the Department.
Kevin E. Bryant,
Deputy Director, Office of Directives Management, U.S. Department of
State.
[FR Doc. 2022-25253 Filed 11-18-22; 8:45 am]
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