41084 Federal Register / Vol. 62, No. 147 / Thursday, July 31, 1997 / Notices

Maine

Gail Thayer, UI Director, Bureau of

Employment Security, 20 Union Street,

Augusta, ME 04330, (207) 287–2316

Maryland

Thomas S. Wendel, Exec. Director,

Unemployment Insurance Division, Dept.

of Labor, Licensing and Regulation, 1100

North Eutaw Street, Baltimore, MD 21201,

(410) 767–2464

Massachusetts

Rena Kottcamp, Director of Research, Divisin

of Employment Security, Charles F. Hurley

ES Building, Boston, MA 02114, (617) 626–

6556

Michigan

Manuel Mejia, Deputy Director, Bureau of

Audits and Investigations, Michigan

Employment Security Agency, 7310

Woodward Avenue, Detroit, MI48202,

(313) 876–5906

Minnesota

Marti Hiras, QC Supervisor, Minnesota

Department of Economic Security, 390

North Robert Street, St. Paul, MN 55101,

(612) 296–5347

Mississippi

Merrill Merkle, Quality Control Unit, (601)

961–7764, or

Don Ware, UI Technical Services, (601) 961–

7752

both at:

Mississippi Employment Security Comm.,

P.O. Box 1699, Jackson, MS 39205–1699

Missouri

Marilyn A. Hutcherson, Asst. Dir.,

Unemployment Insurance, Missouri

Division of Employment Security, P.O. Box

59, Jefferson City, MO 65104, (314) 751–

3670

Montana

Rod Sager, Administrator, Dept. of Labor and

Industry Unemployment Insurance

Division, P.O. Box 1728, Helena, MT

59624, (406) 444–2723

Nebraska

Will Sheehan, Administrator, UI Benefits, or

Don Gammill, Administrator, UI Program

Evaluation

both at:

P.O. Box 94600, Lincoln, NE 68509–4600,

(402) 471–9000

Nevada

Karen Rhodes, Public Information Officer,

Department of Employment, Training, and

Rehabilitation, 500 E. Third Street, Carson

City, NV 897113, (702) 687–4620

New Hampshire

Carolyn Angle, QC Supervisor, Quality

Control Unit, NH Department of

Employment Security, 10 West Street,

Concord, NH 03301, (603) 228–4073

New Jersey

Paulette Laubsch, Assistant Commissioner,

New Jersey Department of Labor, CN 110,

Trenton, NJ 08625–0110, (609) 984–5666

New Mexico

Betty Campbell, BQC Supervisor, Quality

Control Section, New Mexico Department

of Labor, 401 Broadway NE., P.O. Box

1928, Albuquerque, NM 87103, (505) 841–

8499

New York

Ina Lawson, QC Manager, Division of Audit

& Compliance, New York State Department

of Labor, State Campus—Building 12,

Albany, NY 12240, (518) 457–3638

North Carolina

W. Howard Phillips, Supervisor, UI

Technical Support, Employment Security

Commission of NC, P.O. Box 25903,

Raleigh, NC 27611, (919) 733–4893

North Dakota

Leo Jablonski, BAM Supervisor, Job Service

North Dakota, P.O. Box 5507, Bismarck,

ND 58506–5507, (701) 328–3355

Ohio

Carolyn Clayton, QC Chief, Ohio Bureau of

Employment Services, 145 South Front

Street, P.O. Box 1618, Columbus, OH

43216, (614) 466–2681

Oklahoma

Terry W. McHale, QC Supervisor, OK

Employment Security Commission, Will

Rogers Memorial Office Bldg., 5th floor,

Oklahoma City, OK 73105, (405) 557–7206

Oregon

James Mosley, QC Supervisor, Oregon

Employment Department, 875 Union Street

N.E., Salem, OR 97311, (503) 373–7963

Pennsylvania

Pete Cope, Director, Bureau of

Unemployment Compensation, Benefits

and Allowances Division, Department of

Labor & Industry, 615 Labor and Industry

Building, Harrisburg, PA 17121, (717) 787–

3547

Puerto Rico

Carmen O. McCulloch, Assistant Secretary,

PR Dept. of Labor and Human Resources,

505 Mun ̃ oz Rivera Avenue, Hato Rey, PR

00918, (787) 754–2130

Rhode Island

Lawrence Fitch, Director, Department of

Employment Security, 24 Mason Street,

Providence, RI 02903, (401) 277–3648

South Carolina

William H. Griffin, Deputy Exec. Dir.

Unemployment Insurance, SC Employment

Security Commission, P.O. Box 995,

Columbia, SC 29202, (803) 737–2400

South Dakota

Dennis Angerhofer, Unemployment

Insurance Division, Department of Labor,

P.O. Box 4730, Aberdeen, SD 57402–4730,

(605) 622–3089

Tennessee

Ann Ridings, BQC Supervisor, Quality

Control Unit, TN Department of

Employment Security, 10th Floor,

Volunteer Plaza, 500 James Robertson

Parkway, Nashville, TN 37245–0001, (615)

741–3190

Texas

Gerald Smart, UI QC Supervisor, Texas

Workforce Commission, TWC Building,

101 E. 15th Street, Austin, TX 78778–0001,

(512) 475–1719

Utah

Robert Comfort, QC Supervisor, Dept. of

Employment Security, P.O. Box 778, Salt

Lake City, UT 84110–0778, (801) 536–7605

Vermont

Robert Herbst, Quality Control Chief, Dept. of

Employment & Training, P.O. Box 488,

Montpelier, VT 05602, (802) 828–4382

Virginia

F.W. Tucker, IV; Chief of Benefits,

Unemployment Insurance Services,

Virginia Employment Commission, P.O.

Box 1359, Richmond, VA 23211, (804)

786–3032

Washington

Teresa Morris, Director, WA Employment

Security Dept., Office of Management

Review, P.O. Box 90465, Olympia, WA

98507–9046, (206) 493–9511

West Virginia

Dennis D. Redden, Bureau of Employnment

Programs, 112 California Avenue,

Charleston, WV 25305, (304) 558–2256

Wisconsin

Chet Frederick, QC Director, WI Dept. of

Workforce Development, 201 East

Washington Avenue, P.O. Box 7905,

Madison, WI 53707, (608) 266–8260

Wyoming

Beth Nelson, Administrator, U I

Administration, P.O. Box 2760, Casper,

WY 82602, (307) 235–3254

[FR Doc. 97–20105 Filed 7–30–97; 8:45 am]

BILLING CODE 4510–30–M

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
Federal Register / Vol. 62, No. 147 / Thursday, July 31, 1997 / Notices 41085

Employment Standards Administration

is soliciting comments concerning a

proposed extension information

collection, the Uniform Health

Insurance Claim Form.

Copies of the proposed information

collection requests 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

addressee section below on or before

September 30, 1997. 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.

ADDRESSES: Ms. Margaret Sherrill, U.S.

Department of Labor, 200 Constitution

Ave., NW., Room S–3201, Washington,

DC 20210, telephone (202) 219–7601.

(This is not a toll-free number.) Fax

202–219–6592.

SUPPLEMENTARY INFORMATION:

I. Background

The Office of Workers’ Compensation

has responsibility for administering the

Federal Employees’ Compensation Act

(FECA—5 USC 8101 et. seq.) and the

Federal Black Lung Benefits Act

(FBLBA) provisions of the Federal Mine

Safety and Health Act (30 USC 901 et.

seq.). These statutes provide for

payment to medical institutions for

certain medical treatment and

diagnostic services for employmentrelated injuries and illnesses. To

determine appropriate payment of

medical bills submitted by such

provider(s), both FECA and FBLA

programs require the billing

institution(s) to identify the claimant/

beneficiary and to specify (1) the type of

injury/illness being treated, (2) the need

for the medical services rendered, (3)

the specific procedure(s) performed, and

(4) the relationship to the accepted

industrial injury/illness for FECA

claimants and to coal mine workers’

pneumoconiosis for Black Lung

claimants.

II. Current Actions

The Department of Labor (DOL) seeks

extension of approval to collect this

information to carry out its

responsibility to insure that providers of

medical services to FECA and BLBA

beneficiaries receive appropriate

payment for injuries and illnesses

covered under the Acts. Failure to

request this information will prohibit

the Department’s ability to fulfill this

mandate.

Type of Review: Extension.

Agency: Employment Standards

Administration.

Title: Uniform Health Insurance Claim

Form.

OMB Number: 1215–0176.

Agency Numbers: UB–92.

Affected Public: Individuals or

households, State or local governments,

Businesses or other for profit, Federal

agencies or employees, Not-for-profit

institutions, Small businesses or

organizations.

Total Repondents: 138,382.

Frequency: On occasion.

Total Responses: 138,382.

Average Time Per Response:

UB–92 FECA—17 minutes

UB–92 FBLBA—7 minutes

EOB FECA—7 minutes

Estimated Total Burden Hours:

31,889.

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 requests; they

will also become a matter of public

record.

Dated: July 24, 1997.

Margaret J. Sherrill,

Management Analysis Officer, Division

Financial Management, Office of

Management, Administration and Planning,

Employment Standards Administration.

[FR Doc. 97–20101 Filed 7–30–97; 8:45 am]

BILLING CODE 4510–27–M

DEPARTMENT OF LABOR

Mine Safety and Health Administration

Proposed Information Collection

Request Submitted for Public

Comment and Recommendations;

Gamma Radiation Exposure Records

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 (PRA

95) [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 Mine Safety and Health

Administration (MSHA) is soliciting

comments concerning the proposed

new/revision/extension/reinstatement

of the information collection related to

Gamma Radiation Exposure Records

(pertains to metal and nonmetal

underground mines). MSHA 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.

A copy of the proposed information

collection request can be obtained by

contacting the employee listed below in

the For Further Information Contact

section of this notice.

DATES: Submit comments on or before

September 29, 1997.