[Federal Register Volume 70, Number 155 (Friday, August 12, 2005)]
[Notices]
[Pages 47234-47235]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 05-16026]


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DEPARTMENT OF LABOR

Office of the Secretary


Submission for OMB Review: Comment Request

August 8, 2005.
    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 e-mail: [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 currently approved collection.
    Title: Application of the Employee Polygraph Protection Act.
    OMB Number: 1215-0170.
    Form Number: WH-1481.
    Frequency: On occasion.
    Type of Response: Recordkeeping, and third party disclosure.
    Affected Public: Business and other for-profit, not-for-profit 
institutions, and farms.
    Number of Respondents: 328,000.
    Annual Reponses: 328,000.
    Average Response Time: Varies from 1 minute to 30 minutes, 
depending on the notice.
    Total Annual Burden Hours: 68,739.
    Total Annualized capital/startup costs: $0.
    Total Annual Costs (operating/maintaining systems or purchasing 
services): $0.
    Description: The Wage and Hour Division (WHD) of the Department of 
Labor (DOL) administers the Employee Polygraph Protection Act of 1988 
(EPPA), 29 U.S.C. 2001 et seq. The EPPA prohibits most private 
employers from using any lie detector tests either for pre-employment 
screening or during the course of employment. The Act contains an 
exemption applicable to Federal, State and local government employers. 
The EPPA also contains several limited exemptions authorizing polygraph 
tests under certain conditions, including testing: (1) By the Federal 
Government of experts, consultants or employees of Federal contractors 
engaged in national security intelligence or counterintelligence 
functions; (2) of employees the employer reasonably suspects of 
involvement in a workplace incident resulting in economic loss or 
injury to the employer's business; (3) of some prospective employees of 
private armored cars, security alarm and security guard firms; and (4) 
of some current and prospective employees of certain firms authorized 
to manufacture, distribute or dispense controlled substances. The WHD 
may assess civil money penalties of up to $10,000 against employers who 
violate any EPPA provision. DOL currently has no printed public use 
forms associated with this information collection that consists of 
third-party disclosures and recordkeeping requirements. Appendix A of 
Regulations, 29 CFR part 801, contains a written statement setting 
forth both the examinee's and employer's legal rights, for use in 
satisfying the EPPA section 8(b)(2)(d) disclosure requirement. DOL 
proposes to make the information in Appendix A available on an optional 
public use form that will be available through the Departmental 
Internet website in PDF format.
    Agency: Employment Standards Administration.
    Type of Review: Extension of currently approved collection.
    Title: Representative Payee Report, Representative Payee Report, 
Short Form, and Physician's Medical Officer's Statement.
    OMB Number: 1215-0173.
    Form Numbers: CM-623, CM-623S, and CM-787.
    Frequency: On occasion.
    Type of Response: Reporting.
    Affected Public: Individuals or households, business and other for-
profit, and not-for-profit institutions.
    Number of Respondents: 5,339.

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                                                            Estimated number
                           Form                                 of annual     Average response  Estimated annual
                                                                responses       time  (hours)     burden hours
----------------------------------------------------------------------------------------------------------------
CM-623....................................................             3,344              1.50             5,016
CM-623S...................................................             1,015              0.17               169
CM-787....................................................               980              0.25               245
    Total.................................................             5,339  ................             5,430
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    Total Annualized capital/startup costs: $0.
    Total Annual Costs (operating/maintaining systems or purchasing 
services): $0.
    Description: The Office of Workers' Compensation Programs 
administers the Federal Black Lung Workers' Compensation Program. Under 
the Federal Mine Safety and Health Act (30 U.S.C. 901) benefits due a 
DOL black lung beneficiary may be paid to a representative payee on 
behalf of the beneficiary when the beneficiary is unable to manage his/
her benefits due to

[[Page 47235]]

incapability, incompetence, or minority. The CM-623, Representative 
Payee Report is used to collect expenditure data regarding the 
disbursement of the beneficiary's benefits by the representative payee 
to assure that the beneficiary's needs are being met. The CM-623S, 
Representative Payee Report, Short Form is a shortened version of the 
CM-623 that is used when the representative payee is a family member. 
The CM-787, Physician's/Medical Officer's Statement is a form used by 
OWCP to gather information from the beneficiary's physician about the 
capability of the beneficiary to manage monthly benefits. It is used by 
OWCP to determine if it is in the beneficiary's best interest to have 
his/her benefits managed by another party. The regulatory authority for 
collecting this information is at 20 CFR 725.506, 510, 511, and 513.

Darrin A. King,
Acting Departmental Clearance Officer.
[FR Doc. 05-16026 Filed 8-11-05; 8:45 am]
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