This PDF is the current document as it appeared on Public Inspection on 08/23/2016 at 08:45 am.
The Department of Labor (DOL) is submitting 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 Start Printed Page 57938Reduction Act (PRA) of 1995 (44 U.S.C. 3501 et seq.). Public comments on the ICR are invited.
The OMB will consider all written comments that agency receives on or before September 23, 2016.
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=201602-1240-003 (this link will only become active on the day following publication of this notice) or by contacting Michel Smyth by telephone at 202-693-4129, TTY 202-693-8064, (these are not toll-free numbers) or sending an email to DOL_PRA_PUBLIC@dol.gov.
Submit comments about this request by mail or courier 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; by Fax: 202-395-5806 (this is not a toll-free number); or by email: OIRA_submission@omb.eop.gov. Commenters are encouraged, but not required, to send a courtesy copy of any comments by mail or courier to the U.S. Department of Labor—OASAM, Office of the Chief Information Officer, Attn: Departmental Information Compliance Management Program, Room N1301, 200 Constitution Avenue NW., Washington, DC 20210; or by email: DOL_PRA_PUBLIC@dol.gov.Start Further Info
FOR FURTHER INFORMATION CONTACT:
Contact Michel Smyth by telephone at 202-693-4129, TTY 202-693-8064, (these are not toll-free numbers) or sending an email to DOL_PRA_PUBLIC@dol.gov.End Further Info End Preamble Start Supplemental Information
This ICR seeks approval under the PRA for revisions to the Claim for Compensation by a Dependent Information Reports information collection. 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. Specifically, this ICR covers Forms CA-5 (Claim for Compensation by Widow, Widower, and/or Children), CA-5b (Claim for Compensation by Parents, Brothers, Sisters, Grandparents, or Grandchildren), CA-1031 (Claimant Support of Dependent), and CA-1074 (Request for Clarification of CA-5b), as well as related form letters used to obtain follow-up information commonly needed to clarify an initial benefit claim. This information collection is considered a revision, because several clarifying changes were made to the forms and letters; however, the changes do not affect the estimated burden. Federal Employee Compensation Act as amended sections 28 and 32 authorize this information collection. See 5 U.S.C. 8145 and 8149.
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 August 31, 2016; however, the DOL notes 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. For additional substantive information about this ICR, see the related notice published in the Federal Register on March 8, 2016 (81 FR 12129).
Interested parties are encouraged to send comments to the OMB, Office of Information and Regulatory Affairs at the address shown in the ADDRESSES section within thirty (30) days of publication of this notice in the Federal Register. 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.
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: 1,675.
Total Estimated Number of Responses: 1,675.
Total Estimated Annual Time Burden: 964 hours.
Total Estimated Annual Other Costs Burden: $871.Start Signature
Dated: August 18, 2016.
Departmental Clearance Officer.
[FR Doc. 2016-20262 Filed 8-23-16; 8:45 am]
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