Proposed Collection; Comment Request
[03/08/2004]
Volume 69, Number 45, Page 10761-10762
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DEPARTMENT OF LABOR
Employment Standards Administration
Proposed Collection; Comment Request
ACTION: Notice.
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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: Survivor's Form for
Benefits (CM-912). A copy of the proposed information collection
request can be obtained by contacting the office listed below in the
ADDRESSES section of this Notice.
DATES: Written comments must be submitted to the office listed in the
ADDRESSES section below on or before May 7, 2004.
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
This collection of information is required to administer the
benefit payment provisions of the Black Lung Act for survivors of
deceased miners. Form CM-912 is authorized for use by the Black Lung
Benefits Act 30 U.S.C. 901, et seq., 20 CFR 410.221 and CFR 725.304.
Completion of Form CM-912 constitutes the application for benefits by
survivors and assists DCMWC in determining the survivor's entitlement
to benefits. This information collection is currently approved for use
through August 31, 2004.
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;
[[Page 10762]]
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 gather information to determine
eligibility for benefits of a survivor of a Black Lung Act beneficiary.
Type of Review: Extension.
Agency: Employment Standards Administration.
Title: Survivor's Form for Benefits.
OMB Number: 1215-0069.
Agency Number: CM-912.
Affected Public: Individuals or households.
Total Respondents: 2,800.
Total Annual Responses: 2,800.
Average Time per Response: 8 minutes.
Estimated Total Burden Hours: 373.
Frequency: One time.
Total Burden Cost (Capital/Startup): $0.
Total Burden Cost (Operating/Maintenance): $800.00.
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: March 2, 2004.
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. 04-5075 Filed 3-5-04; 8:45 am
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