[Federal Register Volume 75, Number 157 (Monday, August 16, 2010)]
[Notices]
[Pages 50004-50005]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2010-20090]


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DEPARTMENT OF LABOR

Office of the Secretary


Submission for OMB Review; Comment Request

August 3, 2010.
    The Department of Labor (DOL) hereby announces the submission of 
the following public information collection request (ICR) to the Office 
of

[[Page 50005]]

Management and Budget (OMB) for review and approval in accordance with 
the Paperwork Reduction Act of 1995 (Pub. L. 104-13, 44 U.S.C. chapter 
35). A copy of this ICR, with applicable supporting documentation; 
including, among other things, a description of the likely respondents, 
proposed frequency of response, and estimated total burden may be 
obtained from the RegInfo.gov Web site at http://www.reginfo.gov/public/do/PRAMain or by contacting Linda Watts Thomas on 202-693-4223 
(this is not a toll-free number) and e-mail mail to: [email protected].
    Interested parties are encouraged to send comments to the Office of 
Information and Regulatory Affairs, Attn: OMB Desk Officer for the 
Department of Labor--Office of Workers' Compensation Programs (OWCP), 
Room 10235, Washington, DC 20503, Telephone: 202-395-7316/Fax 202-395-
5806 (these are not toll-free numbers), e-mail: [email protected] within 30 days from the date of this publication 
in the Federal Register. In order to ensure the appropriate 
consideration, comments should reference the applicable OMB Control 
Number (see below).
    The OMB is particularly interested in comments which:
    (1) 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;
    (2) 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;
    (3) Enhance the quality, utility, and clarity of the information to 
be collected; and
    (4) 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.
    Type of Review: Extension.
    Title of Collection: Survivor's Form for Benefits.
    OMB Control Number: 1240-0027.
    Agency Form Number: CM-912.
    Affected Public: Individuals or Households.
    Cost to Federal Government: $27,324.
    Total Estimated Number of Respondents: 1,750.
    Total Estimated Number of Responses: 1,750.
    Total Burden Hours: 233.
    Total Hour Burden Cost (operating/maintaining): $681.50.
    Description: This collection of information is required to 
administer the benefit payment provisions of the Black Lung Act for 
survivors of deceased miners. Completion of this form constitutes the 
application for benefits by survivors and assists in determining the 
survivor's entitlement to benefits. Form CM-912 is authorized for use 
by the Black Lung Benefits Act 30 U.S.C. 901, et seq., 20 CFR 410.221 
and CFR 725.304 and is used to gather information from a survivor of a 
miner to determine if the survivor is entitled to benefits. For 
additional information, see related notice published in the Federal 
Register on March 12, 2010 (Vol. 75 page 11912).

    Dated: August 3, 2010.
Linda Watts Thomas,
Acting Departmental Clearance Officer.
[FR Doc. 2010-20090 Filed 8-13-10; 8:45 am]
BILLING CODE 4510-CK-P