[Federal Register Volume 86, Number 119 (Thursday, June 24, 2021)]
[Notices]
[Pages 33375-33376]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2021-13402]


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DEPARTMENT OF LABOR

Office of Workers' Compensation Programs


Agency Information Collection Activities; Comment Request; 
Request To Be Selected as Payee (CM-910)

AGENCY: Division of Coal Mine Workers' Compensation, Office of Workers' 
Compensation Programs, Department of Labor.

ACTION: Notice.

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SUMMARY: The Department of Labor, as part of its continuing effort to 
reduce paperwork and respondent burden, conducts a pre-clearance 
consultation program to provide the general public and Federal agencies 
with an opportunity to comment on proposed and/or continuing 
collections of information in accordance with the Paperwork Reduction 
Act of 1995 (PRA).

DATES: Consideration will be given to all written comments received by 
August 23, 2021.

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 by 
contacting Anjanette Suggs by telephone at 202-354-9660 or by email at 
[email protected].
    Submit written comments about, or requests for a copy of, this ICR 
by mail or courier to the U.S. Department of Labor, Office of Workers' 
Compensation Programs, Room S3323, and 200 Constitution Avenue NW, 
Washington, DC 20210; by email: [email protected].

FOR FURTHER INFORMATION: Contact Anjanette Suggs by telephone at 202-

[[Page 33376]]

354-9660 or by email at [email protected].

SUPPLEMENTARY INFORMATION: The DOL, as part of continuing efforts to 
reduce paperwork and respondent burden, conducts a pre-clearance 
consultation program to provide the general public and Federal agencies 
an opportunity to comment on proposed and/or continuing collections of 
information before submitting them to the OMB for final approval. This 
program helps to ensure requested data can be provided in the desired 
format, reporting burden (time and financial resources) is minimized, 
collection instruments are clearly understood, and the impact of 
collection requirements can be properly assessed.
    This ICR seeks approval under the PRA for an extension of an 
existing collection titled Request to be Selected as Payee (CM-910). If 
a beneficiary is incapable of handling his/her affairs, the person or 
institution responsible for their care is required to apply to receive 
the benefit payments on the beneficiary's behalf. The CM 910 is the 
form completed by representative payee applicants. The payee applicant 
completes the form and submits it for evaluation to the district office 
that has jurisdiction over the beneficiary's claim file. The Black Lung 
Benefits Act, 30 U.S.C. 901 and its implementing regulations, 20 CFR 
725.513(a), 725.533(e), authorizes this information collection. See 30 
U.S.C. 936(a).
    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 the OMB under the PRA approves it 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.
    Interested parties are encouraged to provide comments to the 
contact shown in the ADDRESSES section. Written comments will receive 
consideration, and summarized and included in the request for OMB 
approval of the final ICR. To help ensure appropriate consideration, 
comments should mention 1240-0010.
    Submitted comments will also be a matter of public record for this 
ICR and posted on the internet, without redaction. The DOL encourages 
commenters not to include personally identifiable information, 
confidential business data, or other sensitive statements/information 
in any comments.
    The Department of Labor 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 submissions of responses.
    Agency: DOL-OWCP-DCMWC.
    Type of Review: Extension.
    Title of Collection: Request to be Selected as Payee.
    Form: Request to be Selected as Payee, CM-910.
    OMB Control Number: 1240-0010.
    Affected Public: Individuals or households; Business or other for 
profit; Not-for-profit institutions.
    Total Respondents: 200.
    Total Annual Responses: 200.
    Average Time per Response: 15 minutes.
    Estimated Total Burden Hours: 50 hours.
    Frequency: On occasion.
    Total Burden Cost (capital/startup): $0.
    Total Burden Cost (operating/maintenance): $1,230.

(Authority: 44 U.S.C. 3506(c)(2)(A)).

Anjanette Suggs,
Agency Clearance Officer.
[FR Doc. 2021-13402 Filed 6-23-21; 8:45 am]
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