[Federal Register Volume 78, Number 127 (Tuesday, July 2, 2013)]
[Notices]
[Pages 39771-39772]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2013-15737]


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DEPARTMENT OF LABOR

Office of the Secretary


Agency Information Collection Activities; Submission for OMB 
Review; Comment Request; Claim for Compensation by a Dependent 
Information Reports

ACTION: Notice.

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SUMMARY: On July 1, 2013, the Department of Labor (DOL) will submit the 
Office of Workers' Compensation Programs (OWCP) sponsored information 
collection request (ICR) revision titled, ``Claim for Compensation by a 
Dependent Information Reports,'' to the Office of Management and Budget 
(OMB) for review and approval for use in accordance with the Paperwork 
Reduction Act (PRA) of 1995 (44 U.S.C. 3501 et seq.).

DATES: Submit comments on or before July 31, 2013.

ADDRESSES: A copy of this ICR with applicable supporting documentation; 
including a description of the likely respondents, proposed frequency 
of response, and estimated total burden may be obtained free of charge 
from the RegInfo.gov Web site at http://www.reginfo.gov/public/do/PRAViewICR?ref_nbr=201302-1240-001 (this link will only become active 
on July 2, 2013) or by contacting Michel Smyth by telephone at 202-693-
4129 (this is not a toll-free number) or sending an email to [email protected].
    Submit comments about this request to the Office of Information and 
Regulatory Affairs, Attn: OMB Desk Officer for DOL-OWCP, Office of 
Management and Budget, Room 10235, 725 17th Street NW., Washington, DC 
20503, Fax: 202-395-6881 (this is not a toll-free number), email: 
[email protected].

FOR FURTHER INFORMATION CONTACT: Michel Smyth by telephone at 202-693-
4129 (this is not a toll-free number) or by email at [email protected].

    Authority:  44 U.S.C. 3507(a)(1)(D).


SUPPLEMENTARY INFORMATION: This ICR covers forms a dependent of a 
deceased Federal employee, whose death is work-related, uses to prove 
continued eligibility for benefits, to show entitlement to remaining 
compensation payments of the deceased employee, and to show dependency. 
The collection of this information is required by 5 U.S.C. 8110 and 
regulations 20 CFR 10.7, 10.105, 10.410, 10.413, 10.417, 10.535, and 
10.537. Specifically, this ICR covers Forms CA-5, CA-5b, CA-1031, and 
CA-1074, as well as related form letters used to obtain follow-up 
information commonly needed to clarify an initial benefit claim.
    This ICR seeks to revise Forms CA-5 and CA-5b, in order to collect 
information that will allow for the direct deposit of benefit payments 
into a beneficiary's account with a financial institution. In addition, 
the OWCP is adding information about how a respondent with a disability 
may obtain further assistance in responding to the forms and letters 
covered by this ICR. For additional substantive information about this 
ICR, see the related notice published in the Federal Register on March 
12, 2013 (78 FR 15742).
    This information collection is subject to the PRA. A Federal agency 
generally cannot conduct or sponsor a collection of information, and 
the public is generally not required to respond to an information 
collection, unless it is approved by the OMB under the PRA and displays 
a currently valid OMB Control Number. In addition, notwithstanding any 
other provisions of law, no person shall generally be subject to 
penalty for failing to comply with a collection of information that 
does not display a valid Control Number. See 5 CFR 1320.5(a) and 
1320.6. The DOL obtains OMB approval for this information collection 
under Control Number 1240-0013. The current approval is scheduled to 
expire on July 31, 2013; however, it should be noted that existing 
information collection requirements submitted to the OMB receive a 
month-to-month extension while they undergo review. New requirements 
would only take effect upon OMB approval.
    Interested parties are encouraged to send comments to the OMB, 
Office of Information and Regulatory Affairs at the address shown in 
the ADDRESSES section by July 31, 2013. In order to help ensure 
appropriate consideration, comments should mention OMB Control Number 
1240-0013. The OMB is particularly interested in comments that:
     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: DOL-OWCP.
    Title of Collection: Claim for Compensation by a Dependent 
Information Reports.
    OMB Control Number: 1240-0013.
    Affected Public: Individuals or Households.
    Total Estimated Number of Respondents: 2,920.
    Total Estimated Number of Responses: 2,920.
    Total Estimated Annual Burden Hours: 1,571.
    Total Estimated Annual Other Costs Burden: $1,431.


[[Page 39772]]


    Dated: June 24, 2013.
Michel Smyth,
Departmental Clearance Officer.
[FR Doc. 2013-15737 Filed 7-1-13; 8:45 am]
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