Submission for OMB Review; Comment Request
[Notices] [04/01/1999]
Submission for OMB Review; Comment Request
[04/01/1999]
Volume 64, Number 62, Page 15818-15819-----------------------------------------------------------------------
DEPARTMENT OF LABOR
Office of the Secretary
Submission for OMB Review; Comment Request
March 25, 1999.
The Department of Labor (DOL) has submitted the following public
information collection requests (ICRs) to the Office of Management and
Budget (OMB) for review and approval in accordance with the Paperwork
Reduction Act of 1995 (Pub. L. 104-13, 44 U.S.C. Chapter 35). A copy of
each individual ICR, with applicable supporting documentation, may be
obtained by calling the Department of Labor, Departmental Clearance
Officer, Pauline Perrow ({202} 219-5096, ext. 143), or by E-Mail to
Perrow-Pauline@dol.gov.
Comments should be sent to Office of Information and Regulatory
Affairs, Attn: OMB Desk Officers for BLS, DM, ESA, ETA, MSHA, OSHA,
PWBA, or VETS, Office of Management and Budget, Room 10235, Washington,
DC 20503 ({202} 395-7316), on or before May 3, 1999.
OMB 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
electronics submission of responses.
Agency: Employment Standards Administration.
Title: Claim for Continuance of Compensation.
OMB Number: 1215-0154 (Extension).
Frequency: Annually.
Affected Public: Individuals or households.
Number of Respondents: 6,054.
Estimated Time Per Respondent: \1/12\ of an hour.
Total Burden Hours: 505.
Total Annualized capital/startup costs: 0.
Total annual costs (operating/maintaining systems or purchasing
services): $2,000.
Description: This form is used to obtain information on marital
status of beneficiaries in death cases, in order to determine continued
entitlement to benefits under the provisions of the Federal Employees'
Compensation Act. The information provided is used by OWCP claims
examiners to ensure that death benefits being paid are correct, and
that payments are not made to ineligible survivors.
Agency: Employment Standards Administration.
Title: (1) Miner's Claim for Benefits Under the Black Lung Benefits
Act; (2) Employment History; (3) Miner Reimbursement Form.
OMB Number: 1215-0052 (Extension).
Frequency: On-occasion.
Affected Public: Individuals or households; Business or other for-
profit.
Number of Respondents: 20,200.
Estimated Time Per Respondent:
----------------------------------------------------------------------------------------------------------------
Minutes Respondents Hours
----------------------------------------------------------------------------------------------------------------
CM-911 45 4,800 3,600
CM-911a 40 5,900 3,933
CM-915 10 9,500 1,583
----------------------------------------------------------------------------------------------------------------
Total Burden Hours: 9,116.
Total Annualized capital/startup costs: 0.
Total annual costs (operating/maintaining systems or purchasing
services): $4,000.
Description: CM-911 A miner who applies for black lung benefits
must complete the CM-911 (applicant form). The completed form gives
basic identifying information about the applicant, the years of coal
mine employment, dependents, earned income and income received from
state workers' compensation as a result of pneumoconiosis.
CM-915 of the standard data collection form completed by miner
payees when requesting reimbursement for black lung related medical
services that are covered under the program. Miner payees, i.e.,
miners, authorized survivors and representatives, are entitled to
reimbursement for out-of-pocket medical expenses incurred as a result
of treatment for a black lung related condition.
CM-915 provides a systematic approach for gathering data essential
to processing miner submitted medical bills in accordance with the
program objectives.
Agency: Employment Standards Administration.
Title: Pre-Hearing Statement.
OMB Number: 1215-0085 (Extension).
Frequency: On Occasion.
Affected Public: Individuals or households; Business or other for-
profit.
Number of Respondents: 6,800.
Estimated Time Per Respondent: 10 minutes.
Total Burden Hours: 1,088.
Total Annualized capital/startup costs: 0.
Total annual costs (operating/maintaining systems or purchasing
services): $2,500.
Description: This form is used to refer cases for formal hearings
under the Act. The information obtained is used to establish and
clarify the issues involved. The information is used by OWCP district
offices to prepare cases for hearing.
Agency: Employment Standards Administration.
Title: Overpayment Recover Questionnaire.
OMB Number: 1215-0144 (Extension).
Frequency: On-Occasion.
Affected Public: Individuals or households.
Number of Respondents: 4,500.
Estimated Time Per Respondent: one hour each.
Total Burden Hours: 4,500 (FECA: 3,500 and Black Lung 1,000).
Total Annualized capital/startup costs: 0.
Total annual costs (operating/maintaining systems or purchasing
services): 2,000.
Description: The information on this form is used by OWCP examiners
to ascertain the financial condition of the beneficiary to see if the
overpayment or
[[Page 15819]]
any part can be recovered; to identify the possible concealment or
improper transfer of assets; and to identify and consider present and
potential income and current assets for enforced collection
proceedings.
Agency: Employment Standards Administration.
Title: Applications to Employ Special Industrial Home workers and
Workers with Disabilities.
OMB Number: 1215-0005 (Extension).
Frequency: On-Occasion.
Affected Public: Individuals of households; Business or other for
profit; Not-for-Profit institutions; Farms; State, Local, or Tribal
Government.
Number of Respondents: 8,600.
Estimated Time Per Respondent:
----------------------------------------------------------------------------------------------------------------
Minutes Respondents
----------------------------------------------------------------------------------------------------------------
WH-2 30 100
WH-226-MIS 45 8,500
WH-226A-MIS 45 *8,500
----------------------------------------------------------------------------------------------------------------
* A total of 20,000 copies of this form will be completed by 8,500 respondents.
Total Burden Hours: 21,425.
Total Annualized capital/startup costs: 0.
Total annual costs (operating/maintaining systems or purchasing
services): 3,000.
Description: The WH-2 is used by employers to obtain certificates
to employ individual Home workers in one of the restricted homework
industries: knitted outerwear, women's apparel, jewelry manufacturing,
gloves and mittens, button and buckle manufacturing, handkerchief
manufacturing and embroideries. Upon application by the home worker and
the employer, certificates may be issued to the employer authorizing
employment of an individual home worker, provided it is shown that the
worker is unable to adjust to factory work because of age and physical
or mental disability or is unable to leave home because the worker is
required to care for an invalid in the home . . . etc.
The WH-226 and the supplemental data form WH-226A-MIS are used by
employers to obtain authorization to employ workers with disabilities
in competitive employment, in sheltered workshops, and in hospitals or
institutions at subminimum wages which are commensurate with those paid
to nondisabled workers.
Pauline D. Perrow,
Acting Departmental Clearance Officer.
[FR Doc. 99-7834 Filed 3-31-99; 8:45 am]
BILLING CODE 4510-29-M
|
