Proposed Collection; Comment Request [Notices] [11/28/1997]
Proposed Collection; Comment Request
[11/28/1997]
Volume 62, Number 229, Page 63391-63392-----------------------------------------------------------------------
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, Office of Workers'
Compensation Programs, Division of Federal Employees' Compensation is
soliciting comments concerning the following information collection:
Claim for Compensation by Dependents Information Reports. Copies of the
proposed information collection request can be obtained by contacting
the office listed below in the addressee section of this notice.
dates: Written comments must be submitted to the office listed in the
addressee section below on or before February 1, 1998. The Department
of Labor is particularly interested in comments which:
<bullet> 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;
<bullet> 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;
<bullet> Enhance the quality, utility and clarity of the
information to be collected; and
<bullet> 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.
addresses: Contact Ms. Patricia A. Forkel at the U.S. Department of
Labor, 200 Constitution Avenue, N.W., Room S-3201, Washington, D.C.
20210, telephone (202) 219-8713. The Fax number is (202) 219-6592.
(These are not toll-free numbers.)
supplementary information:
Background
The forms in this clearance request are used by Federal employees
and their dependents to claim benefits, prove continued eligibility for
benefits, and to show entitlement to the remaining compensation of a
deceased beneficiary under the Federal Employees' Compensation Act.
There are nine forms in this clearance request; they are the CA-5; CA-
5b; CA-1031; CA-1085; CA-1093; CA-1615; CA-1617; CA-1618, and CA-1074.
Current Actions
The Department of Labor (DOL) seeks extension of approval to
collect this information in order to carry out its responsibility to
meet the statutory requirements of the Federal Employees' Compensation
Act. The information contained in these forms is used by the Division
of Federal Employees' Compensation to determine entitlement to benefits
under the Act, to verify dependent status and to initiate,
[[Page 63392]]
continue, adjust or terminate benefits based on eligibility criteria.
Type of Review: Extension.
Agency: Employment Standards Administration.
Title: Claim for Compensation By Dependents Information Reports.
OMB Number: 1215-0155.
Affected Public: Individuals or households.
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Average
Report Total Frequency Total Min. per Hours
respondents Responses Response
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CA-5............................ 235 Once............................ 235 90 253
CA-5b........................... 70 Once............................ 70 90 105
CA-1615......................... 120 Once............................ 120 30 60
CA-1617......................... 600 Semiannually.................... 600 30 300
CA-1085......................... 450 Once............................ 450 45 338
CA-1031......................... 1,700 Annually........................ 1,700 15 425
CA-1074......................... 70 Once............................ 70 60 70
CA-1093......................... 50 Once............................ 50 30 25
CA-1618......................... 320 Semiannually.................... 320 30 160
------------- ----------- ----------
Totals...................... 3,615 3,615 ......... 1,835
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Total Burden Cost (capital/startup): 0.
Total Burden Cost (operating/maintenance): $1,156.80.
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: November 24, 1997.
Cecily A. Rayburn,
Director, Division of Financial Management Office of Management,
Administration and Planning, Employment Standards Administration.
[FR Doc. 97-31239 Filed 11-26-97; 8:45 am]
BILLING CODE 4510-27-M
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