[Federal Register Volume 74, Number 27 (Wednesday, February 11, 2009)]
[Notices]
[Pages 6942-6943]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: E9-2931]


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DEPARTMENT OF STATE

[Public Notice 6522]


 30-Day Notice of Proposed Information Collection: Form DS-1622 
and DS-1843, Medical History and Examination for Foreign Service, OMB 
1405-0068

ACTION: Notice of request for public comment and submission to OMB of 
proposed collection of information.

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SUMMARY: The Department of State has submitted the following 
information

[[Page 6943]]

collection request to the Office of Management and Budget (OMB) for 
approval in accordance with the Paperwork Reduction Act of 1995.
     Title of Information Collection: Medical History and 
Examination for Foreign Service.
     OMB Control Number: 1405-0068.
     Type of Request: Revision of Currently Approved 
Collection.
     Originating Office: Office of Medical Support, M/MED/C/MC.
     Form Number: DS-1622 and DS-1843.
     Respondents: Foreign Service Officers, State Department 
Employees, Other. Government Employees and Family Members.
     Estimated Number of Respondents: 7,234 per year.
     Estimated Number of Responses: 7,234 per year.
     Average Hours per Response: 1.0 hours per response.
     Total Estimated Burden: 7,234 hours.
     Frequency: On Occasion.
     Obligation to Respond: Mandatory.

DATE(S): Submit comments to the Office of Management and Budget (OMB) 
for up to 30 days from February 11, 2009.

ADDRESSES: Direct comments and questions to Katherine Astrich, the 
Department of State Desk Officer in the Office of Information and 
Regulatory Affairs at the Office of Management and Budget (OMB), who 
may be reached at 202-395-4718. You may submit comments by any of the 
following methods:
     E-mail: [email protected]. You must include the DS form 
number, information collection title, and OMB control number in the 
subject line of your message.
     Mail (paper, disk, or CD-ROM submissions): Office of 
Information and Regulatory Affairs, Office of Management and Budget, 
725 17th Street, NW., Washington, DC 20503.
     Fax: 202-395-6974.

FOR FURTHER INFORMATION CONTACT: You may obtain copies of the proposed 
information collection and supporting documents from Anitra Collins, 
Room L213, 2401 E St., NW., Washington, DC 20052-0101, who may be 
reached on 202-663-1754 or at [email protected].

SUPPLEMENTARY INFORMATION:
    We are soliciting public comments to permit the Department to:
     Evaluate whether the proposed information collection is 
necessary to properly perform our functions.
     Evaluate the accuracy of our estimate of the burden of the 
proposed collection, including the validity of the methodology and 
assumptions used.
     Enhance the quality, utility, and clarity of the 
information to be collected.
     Minimize the reporting burden on those who are to respond, 
including the use of automated collection techniques or other forms of 
technology.
    Abstract of proposed collection:
    Forms DS-1622 and DS-1843 is designed to collect medical 
information to provide medical providers with current and adequate 
information to base decisions on medical suitability for a federal 
employee and family members for assignment abroad. Both forms will 
allow medical personnel to verify that there are sufficient medical 
resources at a diplomatic mission abroad to maintain the health and 
fitness of the individual and family members within the State 
Department medical program.
    Methodology:
    The information collected will be collected through the use of an 
electronic forms engine or by hand written submission using a pre-
printed form.

     Dated: January 14, 2009.
Sharon Ludan,
Executive Director, Office of Medical Services, Department of State.
 [FR Doc. E9-2931 Filed 2-10-09; 8:45 am]
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