[Federal Register Volume 77, Number 144 (Thursday, July 26, 2012)]
[Notices]
[Pages 43826-43827]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2012-18214]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

[Document Identifier OS-0990-0269]


Agency Information Collection Request. 60-Day Public Comment 
Request

AGENCY: Office of the Secretary, HHS.

    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 a proposed information collection request 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.
    To obtain copies of the supporting statement and any related forms 
for the proposed paperwork collections referenced above, email 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 
directed to the OS Paperwork Clearance Officer at the above email 
address within 60-days.
    Proposed Project: Complaint Forms for Discrimination; Health 
Information Privacy Complaints OMB No. 0990-0269--Extension--Office of 
Civil Rights.
    Abstract: The Office for Civil Rights is seeking an extension on an 
approval for a 3-year clearance on a previous collection. Individuals 
may file written complaints with the Office for Civil Rights when they 
believe they have been discriminated against by programs or entities 
that receive Federal financial assistance from the Health and Human 
Service or if they believe that their right to the privacy of protected 
health information has been violated. Annual Number of Respondents: 
frequency of submission is for record keeping and reporting on 
occasion.

[[Page 43827]]



                                        Estimated Annualized Burden Table
----------------------------------------------------------------------------------------------------------------
                                                                     Number of        Average
             Forms                   Type of         Number of     responses per   burden hours    Total burden
                                   respondent       respondents     respondent     per response        hours
----------------------------------------------------------------------------------------------------------------
Civil Rights Complaint Form...  Individuals or              3493               1           45/60            2620
                                 households, Not-
                                 for-profit
                                 institutions.
Health Information Privacy      Individuals or            10,286               1           45/60            7715
 Complaint Form.                 households, Not-
                                 for-profit
                                 institutions.
                                                 ---------------------------------------------------------------
    Total.....................  ................  ..............  ..............  ..............          10,335
----------------------------------------------------------------------------------------------------------------


Keith A.Tucker,
Paperwork Reduction Act Reports Clearance Officer, Office of the 
Secretary.
[FR Doc. 2012-18214 Filed 7-25-12; 8:45 am]
BILLING CODE 4153-01-P