21720 Federal Register / Vol. 80, No. 75 / Monday, April 20, 2015 / Notices 

Transfer Order—Surplus Personal 

Property and Continuation Sheet, 

Standard Form (SF) 123. 

DATES: Submit comments on or before: 

June 19, 2015. 

ADDRESSES: Submit comments 

identified by Information Collection 

3090–0014, Transfer Order—Surplus 

Personal Property and Continuation 

Sheet, Standard Form (SF) 123, by any 

of the following methods: 

• Regulations.gov: http://

www.regulations.gov. Submit comments 

via the Federal eRulemaking portal by 

searching the OMB control number. 

Select the link ‘‘Comment Now’’ that 

corresponds with ‘‘Information 

Collection 3090–0014, Transfer Order— 

Surplus Personal Property and 

Continuation Sheet, Standard Form (SF) 

123’’. Follow the instructions provided 

on the screen. Please include your 

name, company name (if any), and 

‘‘Information Collection 3090–0014, 

Transfer Order—Surplus Personal 

Property and Continuation Sheet, 

Standard Form (SF) 123,’’ on your 

attached document. 

• Fax: 202–501–4067. 

• Mail: General Services 

Administration, Regulatory Secretariat 

Division (MVCB), 1800 F Street NW., 

Washington, DC 20405. ATTN: Ms. 

Flowers/IC 3090–0014. 

Instructions: Please submit comments 

only and cite Information Collection 

3090–0014, Transfer Order—Surplus 

Personal Property and Continuation 

Sheet, Standard Form (SF) 123, in all 

correspondence related to this 

collection. All comments received will 

be posted without change to http://

www.regulations.gov, including any 

personal and/or business confidential 

information provided. 

FOR FURTHER INFORMATION CONTACT: 

Joyce Spalding, Property Disposal 

Specialist, Federal Acquisition Service, 

at telephone 703–605–2888 or via email 

to joyce.spalding@gsa.gov. 

SUPPLEMENTARY INFORMATION: 

A. Purpose 

The Transfer Order—Surplus Personal 

Property and Continuation Sheet, 

Standard form (SF) 123, is used by 

public agencies, nonprofit educational 

or public health activities, programs for 

the elderly, service educational 

activities, and public airports to apply 

for donation of Federal surplus personal 

property. The SF 123 serves as the 

transfer instrument and includes item 

descriptions, transportation 

instructions, nondiscrimination 

assurances, and approval signatures. 

B. Annual Reporting Burden 

Respondents: 20,110. 

Responses per Respondent: 1. 

Total Number of Respondents: 20,110. 

Hours per Response: 0.019. 

Total Burden Hours: 382. 

C. Public Comments 

Public comments are particularly 

invited on: Whether this collection of 

information is necessary and whether it 

will have practical utility; whether our 

estimate of the public burden of this 

collection of information is accurate, 

and based on valid assumptions and 

methodology; ways to enhance the 

quality, utility, and clarity of the 

information to be collected. 

Obtaining Copies of Proposals: 

Requesters may obtain a copy of the 

information collection documents from 

the General Services Administration, 

Regulatory Secretariat Division (MVCB), 

1800 F Street NW., Washington, DC 

20006, telephone 202–501–4755. Please 

cite OMB Control No. 3090–0014, 

Transfer Order—Surplus Personal 

Property and Continuation Sheet, 

Standard Form (SF) 123, in all 

correspondence. 

Dated: April 13, 2015. 

David A. Shive, 

Acting, Chief Information Officer. 

[FR Doc. 2015–08994 Filed 4–17–15; 8:45 am] 

BILLING CODE 6820–34–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Medicare & Medicaid 

Services 

[Document Identifier: CMS–179] 

Agency Information Collection 

Activities: Proposed Collection; 

Comment Request 

AGENCY: Centers for Medicare & 

Medicaid Services, HHS. 

ACTION: Notice. 

SUMMARY: The Centers for Medicare & 

Medicaid Services (CMS) is announcing 

an opportunity for the public to 

comment on CMS’ intention to collect 

information from the public. Under the 

Paperwork Reduction Act of 1995 (the 

PRA), federal agencies are required to 

publish notice in the Federal Register 

concerning each proposed collection of 

information (including each proposed 

extension or reinstatement of an existing 

collection of information) and to allow 

60 days for public comment on the 

proposed action. Interested persons are 

invited to send comments regarding our 

burden estimates or any other aspect of 

this collection of information, including 

any of the following subjects: The 

necessity and utility of the proposed 

information collection for the proper 

performance of the agency’s functions; 

the accuracy of the estimated burden; 

ways to enhance the quality, utility, and 

clarity of the information to be 

collected; and the use of automated 

collection techniques or other forms of 

information technology to minimize the 

information collection burden. 

DATES: Comments must be received by 

June 19, 2015. 

ADDRESSES: When commenting, please 

reference the document identifier or 

OMB control number. To be assured 

consideration, comments and 

recommendations must be submitted in 

any one of the following ways: 

1. Electronically. You may send your 

comments electronically to http://

www.regulations.gov. Follow the 

instructions for ‘‘Comment or 

Submission’’ or ‘‘More Search Options’’ 

to find the information collection 

document(s) that are accepting 

comments. 

2. By regular mail. You may mail 

written comments to the following 

address: CMS, Office of Strategic 

Operations and Regulatory Affairs, 

Division of Regulations Development, 

Attention: Document Identifier/OMB 

Control Number llllll, Room 

C4–26–05, 7500 Security Boulevard, 

Baltimore, Maryland 21244–1850. 

To obtain copies of a supporting 

statement and any related forms for the 

proposed collection(s) summarized in 

this notice, you may make your request 

using one of following: 

1. Access CMS’ Web site address at 

http://www.cms.hhs.gov/Paperwork

ReductionActof1995. 

2. Email your request, including your 

address, phone number, OMB number, 

and CMS document identifier, to 

Paperwork@cms.hhs.gov. 

3. Call the Reports Clearance Office at 

(410) 786–1326. 

FOR FURTHER INFORMATION CONTACT: 

Reports Clearance Office at (410) 786– 

1326. 

SUPPLEMENTARY INFORMATION: 

Contents 

This notice sets out a summary of the 

use and burden associated with the 

following information collections. More 

detailed information can be found in 

each collection’s supporting statement 

and associated materials (see 

ADDRESSES). 

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Federal Register / Vol. 80, No. 75 / Monday, April 20, 2015 / Notices 21721 

CMS–179 State Plan Under Title XIX 

of the Social Security Act (Base Plan 

Pages, Attachments, Supplements to 

Attachments) 

Under the PRA (44 U.S.C. 3501– 

3520), federal agencies must obtain 

approval from the Office of Management 

and Budget (OMB) for each collection of 

information they conduct or sponsor. 

The term ‘‘collection of information’’ is 

defined in 44 U.S.C. 3502(3) and 5 CFR 

1320.3(c) and includes agency requests 

or requirements that members of the 

public submit reports, keep records, or 

provide information to a third party. 

Section 3506(c)(2)(A) of the PRA 

requires federal agencies to publish a 

60-day notice in the Federal Register 

concerning each proposed collection of 

information, including each proposed 

extension or reinstatement of an existing 

collection of information, before 

submitting the collection to OMB for 

approval. To comply with this 

requirement, CMS is publishing this 

notice. 

Information Collection 

1. Type of Information Collection 

Request: Extension of a currently 

approved collection; Title of 

Information Collection: Medicaid State 

Plan Base Plan Pages; Use: State 

Medicaid agencies complete the plan 

pages while we review the information 

to determine if the state has met all of 

the requirements of the provisions the 

states choose to implement. If the 

requirements are met, we will approve 

the amendments to the state’s Medicaid 

plan giving the state the authority to 

implement the flexibilities. For a state to 

receive Medicaid Title XIX funding, 

there must be an approved Title XIX 

state plan. Form Number: CMS–179 

(OMB control number 0938–0193); 

Frequency: Occasionally; Affected 

Public: State, Local, and Tribal 

Governments; Number of Respondents: 

56; Total Annual Responses: 1,120; 

Total Annual Hours: 22,400. (For policy 

questions regarding this collection 

contact Annette Pearson at 410–786– 

6958.) 

Dated: April 15, 2015. 

William N. Parham, III, 

Director, Paperwork Reduction Staff, Office 

of Strategic Operations and Regulatory 

Affairs. 

[FR Doc. 2015–09008 Filed 4–17–15; 8:45 am] 

BILLING CODE 4120–01–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Medicare & Medicaid 

Services 

[Document Identifier: CMS–855R, CMS– 

10394, CMS–10371, CMS–10472 and CMS– 

10494] 

Agency Information Collection 

Activities: Submission for OMB 

Review; Comment Request 

ACTION: Notice. 

SUMMARY: The Centers for Medicare & 

Medicaid Services (CMS) is announcing 

an opportunity for the public to 

comment on CMS’ intention to collect 

information from the public. Under the 

Paperwork Reduction Act of 1995 

(PRA), federal agencies are required to 

publish notice in the Federal Register 

concerning each proposed collection of 

information, including each proposed 

extension or reinstatement of an existing 

collection of information, and to allow 

a second opportunity for public 

comment on the notice. Interested 

persons are invited to send comments 

regarding the burden estimate or any 

other aspect of this collection of 

information, including any of the 

following subjects: (1) The necessity and 

utility of the proposed information 

collection for the proper performance of 

the agency’s functions; (2) the accuracy 

of the estimated burden; (3) ways to 

enhance the quality, utility, and clarity 

of the information to be collected; and 

(4) the use of automated collection 

techniques or other forms of information 

technology to minimize the information 

collection burden. 

DATES: Comments on the collection(s) of 

information must be received by the 

OMB desk officer by May 20, 2015. 

ADDRESSES: When commenting on the 

proposed information collections, 

please reference the document identifier 

or OMB control number. To be assured 

consideration, comments and 

recommendations must be received by 

the OMB desk officer via one of the 

following transmissions: OMB, Office of 

Information and Regulatory Affairs, 

Attention: CMS Desk Officer, Fax 

Number: (202) 395–5806 OR, Email: 

OIRA_submission@omb.eop.gov. 

To obtain copies of a supporting 

statement and any related forms for the 

proposed collection(s) summarized in 

this notice, you may make your request 

using one of following: 

1. Access CMS’ Web site address at 

http://www.cms.hhs.gov/Paperwork

ReductionActof1995. 

2. Email your request, including your 

address, phone number, OMB number, 

and CMS document identifier, to 

Paperwork@cms.hhs.gov. 

3. Call the Reports Clearance Office at 

(410) 786–1326. 

FOR FURTHER INFORMATION CONTACT: 

Reports Clearance Office at (410) 786– 

1326. 

SUPPLEMENTARY INFORMATION: Under the 

Paperwork Reduction Act of 1995 (PRA) 

(44 U.S.C. 3501–3520), federal agencies 

must obtain approval from the Office of 

Management and Budget (OMB) for each 

collection of information they conduct 

or sponsor. The term ‘‘collection of 

information’’ is defined in 44 U.S.C. 

3502(3) and 5 CFR 1320.3(c) and 

includes agency requests or 

requirements that members of the public 

submit reports, keep records, or provide 

information to a third party. Section 

3506(c)(2)(A) of the PRA (44 U.S.C. 

3506(c)(2)(A)) requires federal agencies 

to publish a 30-day notice in the 

Federal Register concerning each 

proposed collection of information, 

including each proposed extension or 

reinstatement of an existing collection 

of information, before submitting the 

collection to OMB for approval. To 

comply with this requirement, CMS is 

publishing this notice that summarizes 

the following proposed collection(s) of 

information for public comment: 

1. Type of Information Collection 

Request: Revision of a currently 

approved collection; Title of 

Information Collection: Medicare 

Enrollment Application: Reassignment 

of Medicare Benefits; Use: The primary 

function of the CMS 855R enrollment 

application is to allow physicians and 

non-physician practitioners to reassign 

their Medicare benefits to a group 

practice and to gather information from 

the individual that tells us who he/she 

is, where he or she renders services, and 

information necessary to establish 

correct claims payment. The goal of 

periodically evaluating and revising the 

CMS–855R enrollment application is to 

simplify and clarify the information 

collection without jeopardizing our 

need to collect specific information. At 

this time, CMS is making very few 

minor revisions to the CMS–855R 

(Reassignment of Benefits) Medicare 

enrollment application (OMB No. 0938– 

1179). Two sections within the form are 

being reversed to maintain sync with 

online and paper forms. The previously 

approved CMS 855R section 2 collected 

information regarding the individual 

practitioner who is reassigning benefits 

and section 3 collected information 

regarding the organization/group 

receiving the reassigned benefits. These 

two sections have been reversed so that 

section 2 now collects information on 

mstockstill on DSK4VPTVN1PROD with NOTICES