[Federal Register Volume 62, Number 229 (Friday, November 28, 1997)]
[Notices]
[Pages 63391-63392]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 97-31239]


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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, 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:
     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 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