[Federal Register Volume 69, Number 109 (Monday, June 7, 2004)]
[Notices]
[Page 31824]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 04-12804]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Office of the Secretary

[Document Identifier: OS-0990-0208]


Agency Information Collection Activities: Proposed Collection; 
Comment Request

AGENCY: Office of the Secretary.
    In compliance with the requirement of section 3506(c)(2)(A) of the 
Paperwork Reduction Act of 1995, the Office of the Secretary (OS), 
Department of Health and Human Services, is publishing the following 
summary of proposed collections for public comment. Interested persons 
are invited to send comments regarding this burden estimate or any 
other aspect of this collection of information, including any of the 
following subjects: (1) The necessity and utility of the proposed 
information collection for the proper performance of the agency's 
functions; (2) the accuracy of the estimated burden; (3) ways to 
enhance the quality, utility, and clarity of the information to be 
collected; and (4) the use of automated collection techniques or other 
forms of information technology to minimize the information collection 
burden.
    #1 Type of Information Collection Request: Extension of a currently 
approved collection.
    Title of Information Collection: Applicant Background Survey.
    Form/OMB No.: OS-0990-0208.
    Use: This form will be used to ask applicants for employment how 
they learned about a vacancy to ensure that recruitment sources yield 
qualified women and minority applicants, as well as applicants with 
disabilities, in compliance with EEOC management directives.
    Frequency: Reporting.
    Affected Public: Individuals or Households.
    Annual Number of Respondents: 30,000.
    Total Annual Responses: 30,000.
    Average Burden Per Response: 2 minutes.
    Total Annual Hours: 1,000.
    To obtain copies of the supporting statement and any related forms 
for the proposed paperwork collections referenced above, access the HHS 
Web site address at http://www.hhs.gov/oirm/infocollect/pending/ or e-
mail your request, including your address, phone number, OMB number, 
and OS document identifier, to [email protected], or call the Reports 
Clearance Office on (202) 690-6162. Written comments and 
recommendations for the proposed information collections must be mailed 
within 30 days of this notice directly to the OMB Desk Officer at the 
address below: OMB Desk Officer: John Kraemer, OMB Human Resources and 
Housing Branch, Attention: (OMB 0990-0208), New Executive 
Office Building, Room 10235, Washington DC 20503.

    Dated: May 26, 2004.
Robert E. Polson,
Office of the Secretary, Paperwork Reduction Act Reports Clearance 
Officer.
[FR Doc. 04-12804 Filed 6-4-04; 8:45 am]
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