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###### Department of Labor

###### Employment Standards Administration 

# ACTION:

Notice. 

# 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: Report of Changes That May Affect Your Black Lung Benefits (CM-929). 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 February 25, 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 Federal Mine Safety and Health Act of 1977 as amended, 30 U.S.C. 941, and 20 CFR 725.533(e) authorizes the Division of Coal Mine Workers' Compensation (DCMWC) to pay compensation to coal miner beneficiaries. Once a miner or survivor is found eligible for benefits, the primary beneficiary is requested to report certain changes that may affect black lung benefits. The CM-929 is used to help determine continuing eligibility of primary beneficiaries receiving black lung benefits from the Black Lung Disability Trust Fund. The CM-929 is completed by the beneficiary to report factors that may affect his or her benefits, including income, marital status, receipt of state workers' compensation and dependents' status. This information collection is currently approved for use through June 30, 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 approval of the extension of this information collection in order to carry out its responsibility to verify the accuracy of information in the beneficiary's claims file, and to identify changes in the beneficiary's status, to ensure that the amount of compensation being paid the beneficiary is accurate. 

*Type of Review:*                     Extension.                 

*Agency:*                     Employment Standards Administration.                 

*Titles:*                     Report of Changes That May Affect Your Black Lung Benefits.                 

*OMB Number:*                     1215-0084.                 

*Agency Numbers:*                     CM-929.                 

*Affected Public:*                     Individuals or households.                 

*Total Respondents:*                     51,000.                 

*Total Annual Responses:*                     51,000.                           ( print page 77272)    

*Estimated Total Burden Hours:*                     4,505.                 

*Estimated Time Per Response:*                     5 to 8 minutes.                 

*Frequency:*                     Biennially.                 

*Total Burden Cost (capital/startup):*                     $0.                 

*Total Burden Cost (operating/maintenance):*                     $0.                 

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: December 20, 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. 04-28189 Filed 12-23-04; 8:45 am] 

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