77270 Federal Register / Vol. 69, No. 247 / Monday, December 27, 2004 / Notices 

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. 

Overview of This Information Collection 

(1) Type of Information Collection:

Revision of a currently approved 

collection. 

(2) Title of the Form/Collection: A 

National Repository for the Collection 

and Inventory of Information Related to 

Arson and the Criminal Misuse of 

Explosives. 

(3) Agency Form Number, if Any, and 

the Applicable Component of the 

Department of Justice Sponsoring the 

Collection: Form Number: None. Bureau 

of Alcohol, Tobacco, Firearms and 

Explosives. 

(4) Affected Public Who Will Be Asked 

or Required To Respond, as Well as a 

Brief Abstract: Primary: State, Local or 

Tribal Government. Other: Federal 

Government. The Federal explosive 

laws require all Federal agencies to 

report to the Attorney General (AG) 

information relating to arson and 

criminal misuse of explosives for entry 

into a national repository. In addition, 

the law provides that such a repository 

will contain information on arson and 

explosives incidents voluntarily 

reported to the Attorney General by 

State, Local or Tribal authorities. The 

ATF National Repository maintains all 

explosive incident databases within the 

Department. 

(5) An Estimate of the Total Number 

of Respondents and the Amount of Time 

Estimated for an Average Respondent to 

Respond: It is estimated that 2,000 

respondents will report the information 

within approximately 10 minutes. 

(6) An Estimate of the Total Public 

Burden (in Hours) Associated With the 

Collection: There are an estimated 333 

annual total burden hours associated 

with this collection. 

If additional information is required 

contact: Brenda E. Dyer, Department 

Clearance Officer, Policy and Planning 

Staff, Justice Management Division, 

Department of Justice, Patrick Henry 

Building, Suite 1600, 601 D Street NW., 

Washington, DC 20530.

Dated: December 20, 2004. 

Brenda E. Dyer, 

Department Clearance Officer, Department of 

Justice.

[FR Doc. 04–28177 Filed 12–23–04; 8:45 am] 

BILLING CODE 4410–FY–P

DEPARTMENT OF LABOR

Office of the Secretary 

Submission for OMB Review: 

Comment Request 

December 14, 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 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 

Employment Standards Administration 

(ESA), 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: Employment Standards 

Administration. 

Type of Review: Extension of a 

currently approved collection. 

Title: Request for Information on 

Earnings, Dual Benefits, Dependents 

and Third Party Settlements. 

OMB Number: 1215–0151. 

Form No.: CA–1032. 

Frequency: Annually. 

Type of Response: Reporting. 

Affected Public: Individuals or 

households. 

Number of Respondents: 50,000. 

Annual Responses: 50,000. 

Average Response Time: 20 minutes. 

Annual Burden Hours: 16,667. 

Total Annualized capital/startup 

costs: $0.

Total Annual Costs (operating/

maintaining systems or purchasing 

services): $20,000. 

Description: The collection of this 

information is necessary under 

provisions of the Federal Employees’

Compensation Act (FECA) which states: 

(1) Compensation must be adjusted to 

reflect a claimant’s earnings while in 

receipt of benefits (5 U.S.C. 8106); (2) 

compensation is payable at the 

augmented rate of 75 percent only if the 

claimant has one or more dependents as 

defined by the FECA (5 U.S.C. 8110); (3) 

compensation may not be paid 

concurrently with certain benefits from 

other Federal Agencies, such as the 

Office of Personnel Management, Social 

Security, and the Veterans 

Administration (5 U.S.C. 8116); (4) 

compensation must be adjusted to 

reflect any settlement from a third party 

responsible for the injury for which the 

claimant is being paid compensation (5 

U.S.C. 8132); (5) an individual 

convicted of any violation related to 

fraud in the application for, or receipt 

of, any compensation benefit, forfeits (as 

of the date of such conviction) any 

entitlement to such benefits, for any 

injury occurring on or before the date of 

conviction (5 U.S.C. 8148(a)); and, (6) 

no Federal compensation benefit can be 

paid to any individual for any period 

during which such individual is 

incarcerated for any felony offense (5 

U.S.C. 8148(b)(1)). The information 

collected through Form CA–1032 is 

used to ensure that compensation being 

paid on the periodic roll is correct. 

Agency: Employment Standards 

Administration. 

Type of Review: Extension of a 

currently approved collection. 

Title: Worker Information—Terms and 

Conditions of Employment. 

OMB Number: 1215–0187. 

Form No. WH–516. 

Frequency: On occasion. 

Type of Response: Third party 

disclosure. 

Affected Public: Farms; Business or 

other for-profit; and Individuals or 

households. 

Federal Register / Vol. 69, No. 247 / Monday, December 27, 2004 / Notices 77271

Number of Respondents: 129,000. 

Annual Responses: 1,594,800. 

Average Response Time: 32 minutes. 

Annual Burden Hours: 68,800. 

Total Annualized capital/startup 

costs: $0. 

Total Annual Costs (operating/

maintaining systems or purchasing 

services): $43,060. 

Description: Various sections of the 

Migrant and Seasonal Agricultural 

Worker Protection Act (MSPA), 29 

U.S.C. 1801 et seq.; require each farm 

labor contractor, agricultural employer 

and agricultural association to disclose 

employment terms and conditions in 

writing to: (a) Migrant agricultural 

workers at the time of recruitment 

(MSPA section 201(a)); (b) seasonal 

agricultural workers, upon request, at 

the time of hire (MSPA section 

301(a)(1)); and (c) seasonal agricultural 

workers employed through a day-haul 

operation at the place of recruitment 

(MSPA section 301(a)(2)). MSPA 

sections 201(b) and 301(b) also require 

that each such respondent provide each 

migrant worker, upon request, a written 

statement of terms and conditions of 

employment. In addition, MSPA 

sections 201(g) and 301(f) require 

providing such information in English 

or, as necessary and reasonable, in a 

language common to the workers and 

that the U.S. Department of Labor (DOL) 

make forms available to provide such 

information. DOL prints and makes 

optional Form WH–516, Worker 

Information—Terms of Conditions of 

Employment, available for this purpose. 

MSPA sections 201(a)(8) and 

301(a)(1)(H) require disclosure of certain 

information regarding State workers’

compensation insurance to each migrant 

or seasonal agricultural worker (i.e., 

whether State workers’ compensation is 

provided and if so, the name of the State 

workers’ compensation insurance 

carrier, the name of each person of the 

policyholder of such insurance, the 

name and the telephone number of each 

person who must be notified of an 

injury or death and the time period 

within which this notice must be given). 

Respondents may also meet this 

disclosure requirement, by providing 

the worker with a photocopy of any 

notice regarding workers’ compensation 

insurance required by law of the state in 

which such worker is employed. The 

terms and conditions required to be 

disclosed to workers are set forth in 

sections 500.75(a) and (b) and 500.75(a), 

(b) and (c) of Regulations, 29 CFR part 

500, Migrant and Seasonal Agricultural 

Worker Protection. Regulations 

500.75(a) and 500.76(a) allow 

respondents to complete and disclose to 

workers the terms and conditions of 

employment using the DOL-developed 

optional form WH–516 to satisfy these 

requirements. Optional Form WH–516 

may be used by the respondent to 

disclose employment terms and 

conditions in writing to migrant and 

seasonal agricultural workers.

Ira L. Mills, 

Departmental Clearance Officer.

[FR Doc. 04–28190 Filed 12–23–04; 8:45 am] 

BILLING CODE 4510–CH–P

DEPARTMENT OF LABOR

Employment Standards Administration 

Proposed Collection; Comment 

Request

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.