Document Headings

                    Document headings vary by document type but may contain                    the following:                  
                -                       the agency or agencies that issued and signed a document                    
                -                       the number of the CFR title and the number of each part                      the document amends, proposes to amend, or is directly                      related to                    
                -                       the agency docket number / agency internal file number                    
                -                       the RIN which identifies each regulatory action listed in                      the Unified Agenda of Federal Regulatory and Deregulatory                      Actions                    

                    See the                                          Document Drafting Handbook                                        for more details.                  

###### Department of Labor

###### Employment Standards Administration

# ACTION:

Notice.

      ( print page 67762)    

# SUMMARY:

                        The Department of Labor, as part of its continuing effort to reduce paperwork and respondent burden, conducts a preclearance 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 (PRA95) (44 U.S.C. 3506(c)(2)(A)). This program helps to ensure that 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 on respondents can be properly assessed. Currently, the Employment Standards Administration is soliciting comments concerning the proposed collection: Claim for Continuance of Compensation (CA-12). A copy of the proposed information collection request can be obtained by contacting the office listed below in the                         **ADDRESSES**                         section of this notice.                    

# DATES:

                        Written comments must be submitted to the office listed in the                         **ADDRESSES**                         section below on or before January 18, 2005.                    

# ADDRESSES:

                        Ms. Hazel M. Bell, U.S. Department of Labor, 200 Constitution Ave., NW., Room S-3201, Washington, DC 20210, telephone (202) 693-0418, fax (202) 693-1451, e-mail                         *bell.hazel@dol.gov.*                         Please use only one method of transmission for comments (mail, fax, or e-mail).                    

# SUPPLEMENTARY INFORMATION

## I. Background

The Office of Workers' Compensation Programs (OWCP) administers the Federal Employees' Compensation Act (FECA), 5 U.S.C. 8133. The Act provides that eligible dependents of deceased employees receive compensation benefits on account of the employee's death. The OWCP monitors death benefits for current marital status, potential for dual benefits, and other criteria for qualifying as a dependent under the law. The CA-12 is sent annually to beneficiaries in death cases to ensure that their status has not changed and that they remain entitled to benefits. This information collection is currently approved for use through May 31, 2005.

## II. Review Focus

The Department of Labor 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 submissions of responses.                

## III. Current Actions

The Department of Labor seeks the extension of approval to collect this information to determine eligibility for benefits.

*Type of Review:*                     Revision.                

*Agency:*                     Employment Standards Administration.                

*Title:*                     Claim for Continuance of Compensation.                

*OMB Number:*                     1215-0154.                

*Agency Number:*                     CA-12.                

*Affected Public:*                     Individuals or households.                

*Total Respondents:*                     5,450.                

*Total Annual Responses:*                     5,450.                

*Average Time per Response:*                     5 minutes.                

*Estimated Total Burden Hours:*                     454.                

*Frequency:*                     Annually.                

*Total Burden Cost (Capital/Startup):*                     $0.                

*Total Burden Cost (Operating/Maintenance):*                     $2,017.00.                

Comments submitted in response to this notice will be summarized and/or included in the request for Office of Management and Budget approval of the information collection request; they will also become a matter of public record.

Dated: November 15, 2004.

Bruce Bohanon,

Chief, Branch of Management Review and Internal Control, Division of Financial Management, Office of Management, Administration and Planning, Employment Standards Administration.

[FR Doc. 04-25686 Filed 11-18-04; 8:45 am]

BILLING CODE 4510-CH-P