[Federal Register Volume 76, Number 38 (Friday, February 25, 2011)]
[Notices]
[Pages 10625-10626]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2011-4285]


-----------------------------------------------------------------------

DEPARTMENT OF LABOR

Office of the Secretary


Agency Information Collection Activities; Submission for OMB 
Review; Comment Request; Request for Information on Earnings, Dual 
Benefits, Dependents, and Third Party Settlements

ACTION: Notice.

-----------------------------------------------------------------------

SUMMARY: The Department of Labor (DOL) is submitting the Office of 
Workers' Compensation Programs (OWCP) sponsored information collection 
request (ICR) titled, ``Request for Information on Earnings, Dual 
Benefits, Dependents, and Third Party Settlements,'' to the Office of 
Management and Budget (OMB) for review and approval for continued use 
in accordance with the Paperwork Reduction Act of 1995 (Pub. L. 104-13, 
44 U.S.C. chapter 35).

DATES: Submit comments on or before March 28, 2011.

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 from the RegInfo.gov Web site, http://www.reginfo.gov/public/do/PRAMain, on the day following publication of this notice or by 
contacting Michel Smyth by telephone at 202-693-4129 (this is not a 
toll-free number) or sending an e-mail to [email protected].
    Submit comments about this request to the Office of Information and 
Regulatory Affairs, Attn: OMB Desk Officer for the Department of Labor, 
Office of Workers' Compensation Programs (OWCP), Office of Management 
and Budget, Room 10235, Washington, DC 20503, Telephone: 202-395-6929/
Fax: 202-395-6881 (these are not toll-free numbers), e-mail: [email protected].

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

SUPPLEMENTARY INFORMATION: Form Letter CA-1032 obtains information from 
a claimant receiving workers' compensation benefits over an extended 
period of time. The OWCP uses his information to determine whether the 
claimant is entitled to continue receiving benefits and whether the 
benefit amount should be adjusted.
    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 if it 
does not display a currently valid OMB control number. See 5 CFR 
1320.5(a) and 1320.6. The DOL obtains OMB approval for this information 
collection under OMB Control Number 1240-0016. The current OMB approval 
is scheduled to expire on February 28, 2011; however, it should be 
noted that information collections submitted to the OMB receive a 
month-to-month extension while they undergo review. For additional 
information, see the related

[[Page 10626]]

notice published in the Federal Register on October 18, 2010 (75 FR 
63863).
    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 30 days of publication of this notice in 
the Federal Register. In order to ensure appropriate consideration, 
comments should reference OMB Control Number 1240-0016. 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: Office of Workers' Compensation Programs (OWCP).
    Title of Collection: Request for Information on Earnings, Dual 
Benefits, Dependents, and Third Party Settlements.
    OMB Control Number: 1240-0016.
    Affected Public: Individuals or households.
    Total Estimated Number of Respondents: 50,000.
    Total Estimated Number of Responses: 50,000.
    Total Estimated Annual Burden Hours: 16,667.
    Total Estimated Annual Costs Burden: $23,500.

    Dated: February 22, 2011.
Michel Smyth,
Departmental Clearance Officer.
[FR Doc. 2011-4285 Filed 2-24-11; 8:45 am]
BILLING CODE 4510-CH-P