[Federal Register Volume 69, Number 247 (Monday, December 27, 2004)]
[Notices]
[Pages 77270-77271]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 04-28190]


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DEPARTMENT OF LABOR

Office of the Secretary


Submission for OMB Review: Comment Request

December 14, 2004.
    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 ICR, with applicable supporting documentation, may be obtained by 
contacting Darrin King on 202-693-4129 (this is not a toll-free number) 
or email: [email protected].
    Comments should be sent to Office of Information and Regulatory 
Affairs, Attn: OMB Desk Officer for the Employment Standards 
Administration (ESA), Office of Management and Budget, Room 10235, 
Washington, DC 20503, 202-395-7316 (this is not a toll-free number), 
within 30 days from the date of this publication in the Federal 
Register.
    The OMB 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 submission of responses.
    Agency: Employment Standards Administration.
    Type of Review: Extension of a currently approved collection.
    Title: Request for Information on Earnings, Dual Benefits, 
Dependents and Third Party Settlements.
    OMB Number: 1215-0151.
    Form No.: CA-1032.
    Frequency: Annually.
    Type of Response: Reporting.
    Affected Public: Individuals or households.
    Number of Respondents: 50,000.
    Annual Responses: 50,000.
    Average Response Time: 20 minutes.
    Annual Burden Hours: 16,667.
    Total Annualized capital/startup costs: $0.
    Total Annual Costs (operating/maintaining systems or purchasing 
services): $20,000.
    Description: The collection of this information is necessary under 
provisions of the Federal Employees' Compensation Act (FECA) which 
states: (1) Compensation must be adjusted to reflect a claimant's 
earnings while in receipt of benefits ( 5 U.S.C. 8106); (2) 
compensation is payable at the augmented rate of 75 percent only if the 
claimant has one or more dependents as defined by the FECA (5 U.S.C. 
8110); (3) compensation may not be paid concurrently with certain 
benefits from other Federal Agencies, such as the Office of Personnel 
Management, Social Security, and the Veterans Administration (5 U.S.C. 
8116); (4) compensation must be adjusted to reflect any settlement from 
a third party responsible for the injury for which the claimant is 
being paid compensation (5 U.S.C. 8132); (5) an individual convicted of 
any violation related to fraud in the application for, or receipt of, 
any compensation benefit, forfeits (as of the date of such conviction) 
any entitlement to such benefits, for any injury occurring on or before 
the date of conviction (5 U.S.C. 8148(a)); and, (6) no Federal 
compensation benefit can be paid to any individual for any period 
during which such individual is incarcerated for any felony offense (5 
U.S.C. 8148(b)(1)). The information collected through Form CA-1032 is 
used to ensure that compensation being paid on the periodic roll is 
correct.
    Agency: Employment Standards Administration.
    Type of Review: Extension of a currently approved collection.
    Title: Worker Information--Terms and Conditions of Employment.
    OMB Number: 1215-0187.
    Form No. WH-516.
    Frequency: On occasion.
    Type of Response: Third party disclosure.
    Affected Public: Farms; Business or other for-profit; and 
Individuals or households.

[[Page 77271]]

    Number of Respondents: 129,000.
    Annual Responses: 1,594,800.
    Average Response Time: 32 minutes.
    Annual Burden Hours: 68,800.
    Total Annualized capital/startup costs: $0.
    Total Annual Costs (operating/maintaining systems or purchasing 
services): $43,060.
    Description: Various sections of the Migrant and Seasonal 
Agricultural Worker Protection Act (MSPA), 29 U.S.C. 1801 et seq.; 
require each farm labor contractor, agricultural employer and 
agricultural association to disclose employment terms and conditions in 
writing to: (a) Migrant agricultural workers at the time of recruitment 
(MSPA section 201(a)); (b) seasonal agricultural workers, upon request, 
at the time of hire (MSPA section 301(a)(1)); and (c) seasonal 
agricultural workers employed through a day-haul operation at the place 
of recruitment (MSPA section 301(a)(2)). MSPA sections 201(b) and 
301(b) also require that each such respondent provide each migrant 
worker, upon request, a written statement of terms and conditions of 
employment. In addition, MSPA sections 201(g) and 301(f) require 
providing such information in English or, as necessary and reasonable, 
in a language common to the workers and that the U.S. Department of 
Labor (DOL) make forms available to provide such information. DOL 
prints and makes optional Form WH-516, Worker Information--Terms of 
Conditions of Employment, available for this purpose. MSPA sections 
201(a)(8) and 301(a)(1)(H) require disclosure of certain information 
regarding State workers' compensation insurance to each migrant or 
seasonal agricultural worker (i.e., whether State workers' compensation 
is provided and if so, the name of the State workers' compensation 
insurance carrier, the name of each person of the policyholder of such 
insurance, the name and the telephone number of each person who must be 
notified of an injury or death and the time period within which this 
notice must be given). Respondents may also meet this disclosure 
requirement, by providing the worker with a photocopy of any notice 
regarding workers' compensation insurance required by law of the state 
in which such worker is employed. The terms and conditions required to 
be disclosed to workers are set forth in sections 500.75(a) and (b) and 
500.75(a), (b) and (c) of Regulations, 29 CFR part 500, Migrant and 
Seasonal Agricultural Worker Protection. Regulations 500.75(a) and 
500.76(a) allow respondents to complete and disclose to workers the 
terms and conditions of employment using the DOL-developed optional 
form WH-516 to satisfy these requirements. Optional Form WH-516 may be 
used by the respondent to disclose employment terms and conditions in 
writing to migrant and seasonal agricultural workers.

Ira L. Mills,
Departmental Clearance Officer.
[FR Doc. 04-28190 Filed 12-23-04; 8:45 am]
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