Federal Register / Vol. 72, No. 43 / Tuesday, March 6, 2007 / Notices 9975 

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 

May 7, 2007. 

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). The Act provides that nonFederal law enforcement officers and/or 

their survivors injured or killed under 

certain circumstances are entitled to 

benefits of the Act to the same extent as 

employees in the Federal government. 

The Notice of Law Enforcement 

Officer’s Injury or Occupational Disease 

(CA–721) and the Notice of Law 

Enforcement Officer’s Death (CA–722) 

are the forms used by non-Federal law 

enforcement officers and their survivors 

to claim compensation under FECA. 

This information collection is currently 

approved for use through August 31, 

2007. 

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: Extension. 

Agency: Employment Standards 

Administration. 

Title: Notice of Law Enforcement 

Officer’s Injury or Occupational Disease 

(CA–721), Notice of Law Enforcement 

Officer’s Death (CA–722). 

OMB Number: 1215–0116. 

Agency Number: CA–721 and CA–

722. 

Affected Public: Individuals or 

Households; Business or other for-profit; 

State, Local or Tribal Government. 

Total Respondents: 30. 

Total Annual Responses: 30. 

Average Time per Response: 60 to 90 

minutes. 

Estimated Total Burden Hours: 40. 

Frequency: On occasion. 

Total Burden Cost (capital/startup): 

$0. 

Total Burden Cost (operating/ 

maintenance): $12.60. 

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. 

Ruben Wiley, 

Chief, Branch of Management Review and 

Internal Control, Division of Financial 

Management, Office of Management, 

Administration and Planning, Employment 

Standards Administration. 

[FR Doc. E7–3865 Filed 3–5–07; 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: Survivor’s Form for 

Benefits (CM–912). 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 

May 7, 2007. 

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 

This collection of information is 

required to administer the benefit 

payment provisions of the Black Lung 

Act for survivors of deceased miners. 

Completion of this form constitutes the 

application for benefits by survivors and 

assists in determining the survivor’s 

entitlement to benefits. Form CM–912 is 

authorized for use by the Black Lung 

Benefits Act 30 U.S.C. 901, et seq., 20 

CFR 410.221 and CFR 725.304 and is 

used to gather information from a 

survivor of a miner to determine if the 

survivor is entitled to benefits. This 

information collection is currently 

approved for use through August 31, 

2007. 

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 


cprice-sewell on PROD1PC67 with NOTICES
9976 Federal Register / Vol. 72, No. 43 / Tuesday, March 6, 2007 / Notices 

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 in order to gather 

information to determine eligibility for 

benefits of a survivor of a Black Lung 

Act beneficiary. 

Type of Review: Extension. 

Agency: Employment Standards 

Administration. 

Title: Survivor’s Form for Benefits. 

OMB Number: 1215–0069. 

Agency Number: CM–912. 

Affected Public: Individuals or 

households. 

Total Respondents: 2,000. 

Total Annual Responses: 2,000. 

Average Time per Response: 8 

minutes. 

Estimated Total Burden Hours: 267. 

Frequency: One time. 

Total Burden Cost (capital/startup): 

$0. 

Total Burden Cost (operating/ 

maintenance): $672.00. 

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. 

Ruben Wiley, 

Chief, Branch of Management Review and 

Internal Control, Division of Financial 

Management, Office of Management, 

Administration and Planning, Employment 

Standards Administration. 

[FR Doc. E7–3866 Filed 3–5–07; 8:45 am] 

BILLING CODE 4510–CK–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: Energy Employees 

Occupational Illness Compensation 

Program Act Forms (EE–1 English and 

EE–1 Spanish, EE–2 English and EE–2 

Spanish, EE–3 English and EE–3 

Spanish, EE–4 English and EE–4 

Spanish, EE–7 English and EE–7 

Spanish, EE–8, EE–9, EE–10, EE–12, 

EE–13, EE–20). A copy of the proposed 

information collection request can be 

obtained by contacting the office listed 

below in the addressee section of this 

Notice. 

DATES: Written comments must be 

submitted to the office listed in the 

addresses section below on or before 

May 7, 2007. 

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) is the primary agency 

responsible for the administration of the 

Energy Employees Occupational Illness 

Compensation Program Act of 2000 as 

amended (EEOICPA or Act), 42 U.S.C. 

7384 et seq. The Act provides for timely 

payment of compensation to covered 

employees and, where applicable, 

survivors of such employees, who 

sustained either ‘‘occupational 

illnesses’’ or ‘‘covered Illnesses’’

incurred in the performance of duty for 

the Department of Energy and certain of 

its contractors and subcontractors. The 

Act sets forth eligibility criteria for 

claimants for compensation under Part 

B and Part E of the Act, and outlines the 

various elements of compensation 

payable from the Fund established by 

the Act. The information collected is 

used to obtain demographic, factual and 

medical information needed to 

determine entitlement to benefits under 

the EEOICPA. Before benefits may be 

paid, the case files must contain 

medical and employment evidence 

showing the claimant’s eligibility. The 

eight forms listed below are reporting 

requirements under the Act and are 

required to determine a claimant’s 

eligibility for compensation and to 

receive benefits under the EEOICPA. 

The forms reporting requirements are: 

EE–1, Claim for Benefits Under Energy 

Employees Occupational Illness 

Compensation Program Act is used to 

file notice of claim under Part B and/or 

E of the EEOICPA, and is to be 

completed by the living current or 

former employee; EE–2, Claim for 

Survivor Benefits Under Energy 

Employees Occupational Illness 

Compensation Program Act is used by 

the survivor of a covered employee to 

file notice of claim under Part B and/or 

E of the EEOICPA; EE–3, Employment 

History for Claim Under Energy 

Employees Occupational Illness 

Compensation Program Act is used to 

gather factual information regarding the 

employee’s work history; EE–4, 

Employment History Affidavit for Claim 

Under the Energy Employees 

Occupational Illness Compensation 

Program Act is used to support the 

claimant’s employment history by 

affidavit; EE–7, Medical Requirements 

Under the Energy Employees 

Occupational Illness Compensation 

Program Act informs an employee, 

survivor or physician of the medical 

evidence needed to establish a diagnosis 

of a covered condition; EE–8, Letter to 

Claimant is sent with enclosure EN–8 to 

obtain information on the employees’

smoking history when lung cancer due 

to radiation is claimed; EE–9, Letter to 

Claimant is sent with enclosure EN–9 to 

obtain information concerning the race 

or ethnicity of the employee when skin 

cancer is claimed; EE–10, Claim for 

Additional Wage-Loss and/or 

Impairment Under the EEOICPA is used 

by the covered Part E employee who has 

received an award for wage-loss and/or 

impairment due to ‘‘covered illness’’ to 

claim for subsequent calendar year of 

wage-loss and/or any additional 

impairment; EE–12, Letter to covered 

Part B and E employees receiving 

medical benefits, sent with enclosure 

EN–12 and is used to collect updated 

information about settlements or awards 

in litigation and state workers’

compensation benefits that impact 

continuing entitlement; EE–13, Letter to 

state workers’ compensation authorities, 

sent with enclosure EN–13 and is used 

to identify covered Part E employees 

receiving medical benefits who have 

also been awarded state workers’

compensation for their covered 

illnesses; and EE–20, Letter to Claimant 

is sent with enclosure EN–20 to verify 

acceptance of payment on approved 

claims. This information collection is 

currently approved for use through 

August 31, 2007. 


cprice-sewell on PROD1PC67 with NOTICES