[Federal Register Volume 76, Number 215 (Monday, November 7, 2011)]
[Notices]
[Page 68787]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2011-28715]


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DEPARTMENT OF JUSTICE

[OMB Number 1105-0008]


Agency Information Collection Activities: Proposed Collection; 
Comments Requested: Extension of a Currently Approved Collection; Claim 
for Damage, Injury, or Death

ACTION: 60-Day notice of information collection under review.

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    The Department of Justice (DOJ), Civil Division, will be submitting 
the following information collection request to the Office of 
Management and Budget (OMB) for review and approval in accordance with 
the Paperwork Reduction Act of 1995. The proposed information 
collection is published to obtain comments from the public and affected 
agencies. Comments are encouraged and will be accepted for ``sixty 
days'' until January 6, 2012. This process is conducted in accordance 
with 5 CFR 1320.10.
    Written comments concerning this information collection should be 
sent to the Office of Information and Regulatory Affairs, Office of 
Management and Budget, Attn: DOJ Desk Officer. The best way to ensure 
your comments are received is to email them to [email protected] or fax them to (202) 395-7285. All comments 
should reference the 8 digit OMB number for the collection or the title 
of the collection. If you have questions concerning the collection, 
please contact the Director, Torts Branch, Civil Division, U.S. 
Department of Justice, Washington, DC 20530, or call the DOJ Desk 
Officer at (202) 395-3176.
    Written comments and suggestions from the public and affected 
agencies concerning the proposed collection of information are 
encouraged. Your comments should address one or more of the following 
four points:

--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 agencies 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.

Overview of This Information Collection

    (1) Type of Information Collection: Extension of a currently 
approved collection.
    (2) Title of the Form/Collection: Claim for Damage, Injury, or 
Death.
    (3) Agency form number, if any, and the applicable component of the 
Department sponsoring the collection: Form Number: CIV SF 95. Civil 
Division, U.S. Department of Justice.
    (4) Affected public who will be asked or required to respond, as 
well as a brief abstract: Primary: Individuals or households. Other: 
Business or other for-profit, Not-for-profit institutions, and State, 
Local, or Tribal Governments. Abstract: This form is utilized by those 
persons making a claim against the United States Government under the 
Federal Tort Claims Act.
    (5) An estimate of the total number of respondents and the amount 
of time estimated for an average respondent to respond/reply: It is 
estimated that there will be 100,000 respondents who will each require 
6 hours to respond.
    (6) An estimate of the total public burden (in hours) associated 
with the collection: The total estimated annual burden hours to 
complete the certification form is 600,000 hours.
    If additional information is required contact: Jerri Murray, 
Department Clearance Officer, United States Department of Justice, 
Justice Management Division, Policy and Planning Staff, Two 
Constitution Square, 145 N Street NE., Room 2E-508, Washington, DC 
20530.

Jerri Murray,
Department Clearance Officer, PRA, United States Department of Justice.
[FR Doc. 2011-28715 Filed 11-4-11; 8:45 am]
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