Federal Register / Vol. 69, No. 187 / Tuesday, September 28, 2004 / Notices 57963

• 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: Employment Standards 

Administration. 

Type of Review: Extension of 

currently approved collection. 

Title: Applications to Employ Special 

Industrial Homeworkers and Workers 

with Disabilities. 

OMB Number: 1215–0005. 

Frequency: On occasion; Semiannually; and Annually. 

Type of Response: Reporting. 

Affected Public: Business and other 

for-profit; Individuals or households; 

Not-for-profit institutions; Farms; and 

State, Local, or Tribal Government. 

Number of Respondents: 4,550.

Form Annual

responses 

Average

response

time

(hours) 

Annual

burden

hours 

WH–2 ........................................................................................................................................... 50 0.5 25 

WH–226 ....................................................................................................................................... 4,500 0.75 3,375 

WH–226A ..................................................................................................................................... 12,000 0.75 9,000 

Total ...................................................................................................................................... 16,550 ........................ 12,400 

Total Annualized Capital/Startup 

Costs: $0. 

Total Annual Costs (Operating/

Maintaining Systems or Purchasing 

Services): $1,820. 

Description: This collection of 

information is necessary to determine 

whether respondents will be authorized 

to pay sub-minimum wages to 

handicapped individuals and employ 

homeworkers in the restricted industries 

under the provisions of sections 11(d) 

and 14(c) of the Fair Labor Standards 

Act. 

Agency: Employment Standards 

Administration. 

Type of Review: Extension of 

currently approved collection. 

Title: Application for Approval of a 

Representative’s Fee in Black Lung 

Claim Proceedings Conducted by the 

U.S. Department of Labor. 

OMB Number: 1215–0171. 

Frequency: On occasion. 

Type of Response: Reporting. 

Affected Public: Business or other forprofit. 

Number of Respondents: 255. 

Annual Responses: 255. 

Average Response Time: 42 minutes. 

Annual Burden Hours: 179. 

Total Annualized Capital/Startup 

Costs: $0. 

Total Annual Costs (Operating/

Maintaining Systems or Purchasing 

Services): $102. 

Description: The purpose of the Form 

CM–972 is to collect pertinent data to 

determine if the a representative’s 

services and fees can be paid under the 

Black Lung Benefits Act (30 U.S.C. 901 

and 20 CFR 725.365 and 725.366).

Ira L. Mills, 

Departmental Clearance Officer.

[FR Doc. 04–21656 Filed 9–27–04; 8:45 am] 

BILLING CODE 4510–CK–P

DEPARTMENT OF LABOR

Office of the Secretary 

Submission for OMB Review; 

Comment Request 

September 21, 2004. 

The Department of Labor (DOL) has 

submitted the following public 

information collection request (ICR) to 

the Office of 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 each 

ICR, with applicable supporting 

documentation, may be obtained by 

contacting the Department of Labor 

(DOL). To obtain documentation, 

contact Ira Mills on (202) 693–4122 (this 

is not a toll-free number) or e-mail: 

mills.ira@dol.gov.

Comments should be sent to Office of 

Information and Regulatory Affairs, 

Attn: OMB Desk Officer for DOL, Office 

of Management and Budget, Room 

10235, Washington, DC 20503, (202) 

395–7316 (this is not a toll-free 

number), within 30 days from the date 

of this publication in the Federal 

Register. 

The OMB is particularly interested in 

comments which: 

• 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: Employment and Training 

Administration. 

Type of Review: Revision of a 

currently approved collection. 

Title: Resource Justification Model. 

OMB Number: 1205–0430. 

Frequency: Annually. 

Affected Public: State, local, or tribal 

government; Federal Government.

Cite/reference Total respondents Frequency Total responses 

Average time per 

response (hours) Burden (hours) 

Crosswalk ............................................................................. 53 Annually 53 120 6,360

57964 Federal Register / Vol. 69, No. 187 / Tuesday, September 28, 2004 / Notices 

Cite/reference Total respondents Frequency Total responses 

Average time per 

response (hours) Burden (hours) 

Account Summary ................................................................ 53 Annually 53 4 212

RJM 1 through 6 series ....................................................... 53 Annually 53 3 159

Narrative ............................................................................... 53 Annually 53 8 424

Totals ............................................................................ ...................... ...................... 212 33.75 7,155

Total Burden Hours: 7,155. 

Total Annualized Capital/Startup 

Costs: $0. 

Total Annual Costs (Operating/

Maintaining Systems or Purchasing 

Services): $375,000. 

Description: This program would 

replace the current methodologies for 

budget formulation and grant allocation 

to the states for unemployment 

insurance program.

Ira L. Mills, 

Departmental Clearance Officer.

[FR Doc. 04–21657 Filed 9–27–04; 8:45 am] 

BILLING CODE 4510–30–P

DEPARTMENT OF LABOR

Office of the Secretary 

Submission for OMB Review: 

Comment Request 

September 22, 2004. 

The Department of Labor (DOL) has 

submitted the following public 

information collection requests (ICRs) to 

the Office of 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 each 

ICR, with applicable supporting 

documentation, may be obtained by 

contacting the Department of Labor 

(DOL). To obtain documentation, 

contact Darrin King on 202–693–4129 

(this is not a toll-free number) or email: 

king.darrin@dol.gov. 

Comments should be sent to Office of 

Information and Regulatory Affairs, 

Attn: OMB Desk Officer for the Mine 

Safety and Health Administration 

(MSHA), Office of Management and 

Budget, Room 10235, Washington, DC 

20503, 202–395–7316 (this is not a tollfree number), within 30 days from the 

date of this publication in the Federal 

Register. 

The OMB is particularly interested in 

comments which: 

• 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: Mine Safety and Health 

Administration. 

Type of Review: Extension of 

currently approved collection. 

Title: Record of Results of 

Examinations of Self-Rescuers 

(Underground Coal Mines). 

OMB Number: 1219–0044. 

Frequency: Quarterly. 

Type of Response: Recordkeeping. 

Affected Public: Business or other forprofit. 

Number of Respondents: 773. 

Number of Annual Responses:

143,592. 

Estimated Time Per Response: 30 

minutes to certify and document that an 

examination was conducted and 1 

minute to document why a device was 

taken out of service. 

Total Burden Hours: 71,748. 

Total Annualized capital/startup 

costs: $0. 

Total Annual Costs (operating/

maintaining systems or purchasing 

services): $0. 

Description: Title 30, CFR 75.1714–

3(b), (c), (d), and (e) require that selfrescuers be examined regularly at 

intervals not to exceed 90 days by a 

qualified person who certifies by date 

and signature that the tests were 

conducted. A record must be made 

when a self-rescue device is removed 

from service and when corrective action 

is taken as a result of the examination. 

The records are used as an enforcement 

tool to insure that the devices have been 

examined and are maintained in 

operable and usable condition.

Agency: Mine Safety and Health 

Administration. 

Type of Review: Extension of 

currently approved collection. 

Title: Escape and Evacuation Plans 30 

CFR 57.11053. 

OMB Number: 1219–0046. 

Frequency: On occasion and semiannually. 

Type of Response: Recordkeeping and 

Third party disclosure. 

Affected Public: Business or other forprofit. 

Number of Respondents: 243. 

Number of Annual Responses: 486. 

Estimated Time Per Response: 8.5 

hours. 

Total Burden Hours: 4,131. 

Total Annualized capital/startup 

costs: $0. 

Total Annual Costs (operating/

maintaining systems or purchasing 

services): $0. 

Description: Title 30 CFR 57.11053 

requires the development of an escape 

and evacuation plan specifically 

addressing the unique conditions of 

each underground metal and nonmetal 

mine. Section 57.11053 also requires 

that revisions be made as mining 

progresses. The plan must be available 

to the inspector and conspicuously 

posted at locations convenient to all 

persons on the surface and 

underground. The information is 

prepared by the mine operator for use 

by miners, MSHA, and persons involved 

in rescue operations.

Darrin A. King, 

Acting Departmental Clearance Officer.

[FR Doc. 04–21658 Filed 9–27–04; 8:45 am] 

BILLING CODE 4510–43–P

DEPARTMENT OF LABOR

Employee Benefits Security 

Administration 

[Prohibited Transaction Exemption 2004–

16; Application No. D–11203] 

Class Exemption for the 

Establishment, Investment and 

Maintenance of Certain Individual 

Retirement Plans Pursuant to a 

Mandatory Distribution

AGENCY: Employee Benefits Security 

Administration, Department of Labor.

ACTION: Grant of class exemption.