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

###### Office of the Secretary

                    The Department of Labor (DOL) hereby announces the submission of the following public information collection requests (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; 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 Mary Beth Smith-Toomey on 202-693-4223 (this is not a toll-free number)/e-mail:                     *DOL_PRA_PUBLIC@dol.gov.*

                    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 Management and Budget, Room 10235, Washington, DC 20503,                     *Telephone:*                     202-395-7316/                    *Fax:*                     202-395-5806 (these are not toll-free numbers),                     *E-mail: OIRA_submission@omb.eop.gov*                     within 30 days from the date of this publication in the                     **Federal Register**                    .  In order to ensure the appropriate consideration, comments should reference the OMB Control Number (                    *see*                     below).                

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:*                     Office of Workers' Compensation Programs (OWCP).                

*Type of Review:*                     Extension without change of a currently approved collection.                

*Title of Collection:*                     Provider Enrollment Form.                

*OMB Control Number:*                     1215-0137.                

*Agency Form Numbers:*                     OWCP-1168.                

*Affected Public:*                     Private Sector—Businesses and other for-profits.                

*Total Estimated Number of Respondents:*                     70,185.                

*Total Estimated Annual Burden Hours:*                     9,335.                

*Total Estimated Annual Costs Burden (does not include hourly wage costs):*                     $32,987.                

*Description:*                     The Form OWCP-1168 requests profile information on providers that enroll in one (or more) of OWCP's benefit programs so its billing contractor can pay them for services rendered to beneficiaries using its automated bill processing system. For additional information, see related notice published at Volume 74 FR 29721 on June 23, 2009.                

*Agency:*                     Office of Workers' Compensation Programs (OWCP).                

*Type of Review:*                     Extension without change of a currently approved collection.                

*Title of Collection:*                     Uniform Billing Form.                

*OMB Control Number:*                     1215-0176.                

*Agency Form Number:*                     OWCP-04.                

*Affected Public:*                     Private Sector—Businesses and other for-profits, Not-for-profit institutions.                

*Total Estimated Number of Respondents:*                     5,481.                

*Total Estimated Annual Burden Hours:*                     2,558.                

*Total Estimated Annual Costs Burden (does not include hourly wage costs):*                     $0.                

*Description:*                     Form OWCP-04 is used by OWCP and contractor bill payment staff to process bills for medical services provided by hospitals and other institutional medical providers. For additional information, see related notice published at Volume 74 FR 29721 on June 23, 2009.                

Darrin A. King,

Departmental Clearance Officer.

[FR Doc. E9-23944 Filed 10-2-09; 8:45 am]

BILLING CODE 4510-27-P