5808 Federal Register / Vol. 75, No. 23 / Thursday, February 4, 2010 / Notices 

Applications for Secretarial 

certification must be submitted to the 

MSHA Qualification and Certification 

Unit in Denver, Colorado. MSHA Form 

5000–1 provides the coal mining 

industry with a standardized reporting 

format that expedites the certification 

process while ensuring compliance with 

the regulations. The information 

provided on the forms enables the 

Secretary of Labor’s delegate—MSHA, 

Qualification and Certification Unit—to 

determine if the applicants satisfy the 

requirements to obtain the certification 

or qualification. Persons must meet 

certain minimum experience 

requirements depending on the type of 

certification or qualification applied for. 

II. Desired Focus of Comments 

MSHA is particularly interested in 

comments that: 

• 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 in the 

FOR FURTHER INFORMATION section of this 

notice, or viewed on the Internet by 

accessing the MSHA home page 

(http://www.msha.gov/) and selecting 

‘‘Rules & Regs’’, and then selecting 

‘‘FedReg. Docs’’. On the next screen, 

select ‘‘Paperwork Reduction Act 

Supporting Statement’’ to view 

documents supporting the Federal 

Register Notice. 

III. Current Actions 

This request for collection of 

information contains provisions 

whereby persons may be temporarily 

qualified or certified to perform tests 

and examinations; requiring specialized 

expertise; related to miner safety and 

health at coal mines. 

Type of Review: Extension. 

Agency: Mine Safety and Health 

Administration. 

Title: Qualification and Certification 

of Electrical Training. 

OMB Number: 1219–0001. 

Recordkeeping: MSHA Form 5000–1 

is used by instructors, who may be 

mining personnel, consultants, or 

college professors, to report to MSHA 

those miners who have satisfactorily 

completed a coal mine electrical 

training program. Based on the 

information submitted on Form 5000–1, 

MSHA issues certification cards that 

identify these individuals as qualified to 

perform certain tasks at the mine. 

Frequency: On Occasion. 

Affected Public: Business or other forprofit. 

Respondents: 17,960. 

Responses: 2,796. 

Total Burden Hours: 160. 

Total Burden Cost (operating/ 

maintaining): $13,124. 

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. 

Dated at Arlington, Virginia, this 29th day 

of January 2010. 

John Rowlett, 

Director, Management Services Division. 

[FR Doc. 2010–2407 Filed 2–3–10; 8:45 am] 

BILLING CODE 4510–43–P 

DEPARTMENT OF LABOR 

Employee Benefits Security 

Administration 

Publication of Model Notice for 

Employers to Use Regarding Eligibility 

for Premium Assistance Under 

Medicaid or the Children’s Health 

Insurance Program, Notice 

AGENCY: Employee Benefits Security 

Administration, Department of Labor. 

ACTION: Notice of the Availability of the 

Model Notice for Employers Regarding 

Premium Assistance under Medicaid or 

the Children’s Health Insurance 

Program, with Request for Comments. 

SUMMARY: On February 4, 2009, 

President Obama signed the Children’s 

Health Insurance Program 

Reauthorization Act of 2009 (CHIPRA, 

Pub. L. 111–3). CHIPRA includes a 

requirement that the Departments of 

Labor and Health and Human Services 

develop a model notice for employers to 

use to inform employees of potential 

opportunities currently available in the 

State in which the employee resides for 

group health plan premium assistance 

under Medicaid and the Children’s 

Health Insurance Program (CHIP). The 

Department of Labor (Department) is 

required to provide the model notice to 

employers within one year of CHIPRA’s 

enactment. This document announces 

the availability of a Model Employer 

CHIP Notice. This notice also requests 

comments regarding compliance with 

the Employer CHIP Notice requirement 

for use in the development of future 

compliance assistance materials and/or 

regulations. 

DATES: Comment Date: Comments are 

due on or before April 5, 2010. 

ADDRESSES: Written comments may be 

submitted via any of the methods 

specified below. Please do not submit 

duplicates. All comments will be made 

available to the public. Warning: Do not 

include any personally identifiable 

information (such as name, address, or 

other contact information) or 

confidential business information that 

you do not want publicly disclosed. All 

comments are posted on the Internet 

exactly as received, and can be retrieved 

by most Internet search engines. No 

deletions, modifications, or redactions 

will be made to the comments received, 

as they are public records. Comments 

may be submitted anonymously. 

• Federal eRulemaking Portal: http:// 

www.regulations.gov. Follow the 

instructions for submitting comments. 

• E-mail: E–OHPSCA.EBSA@dol.gov. 

• Mail or Hand Delivery: Office of 

Health Plan Standards and Compliance 

Assistance, Employee Benefits Security 

Administration, Room N–5653, U.S. 

Department of Labor, 200 Constitution 

Avenue NW., Washington, DC 20210, 

Attention: Employer CHIP Notice. 

Comments will be posted without 

change to http://www.regulations.gov 

and http://www.dol.gov/ebsa, and 

available for public inspection at the 

Public Disclosure Room, N–1513, 

Employee Benefits Security 

Administration, 200 Constitution 

Avenue, NW., Washington, DC 20210. 

FOR FURTHER INFORMATION CONTACT: 

Amy Turner or Beth Baum, Office of 

Health Plan Standards and Compliance 

Assistance, Employee Benefits Security 

Administration, (202) 693–8335. This is 

not a toll-free number. 

SUPPLEMENTARY INFORMATION: 

I. Purpose 

This document addresses the 

Employer CHIP Notice requirement 

under CHIPRA and announces the 

availability of a model notice that can be 

used to satisfy the content requirements 

for the Employer CHIP Notice. 


srobinson on DSKHWCL6B1PROD with NOTICES
Federal Register / Vol. 75, No. 23 / Thursday, February 4, 2010 / Notices 5809 

1The Employer CHIP Notice requirements in the 

provisions of section 701(f)(3)(B)(i) of ERISA, 

section 2701(f)(3)(B)(i) of the PHS Act, and section 

9801(f)(3)(B)(i) of Code are included within Part 7 

of ERISA, Title XXVII of the PHS Act, and Chapter 

100 of the Code. 

II. Coordination of Administration 

Section 701(f)(3)(B)(i)(II) of the 

Employee Retirement Income Security 

Act (ERISA), as added by CHIPRA, 

requires the Departments of Labor and 

Health and Human Services, in 

consultation with State Medicaid and 

CHIP Agencies, to develop model 

language for the Employer CHIP Notice 

required under section 701(f)(3)(B)(i) of 

ERISA, section 2701(f)(3)(B)(i) of the 

Public Health Service Act (PHS Act), 

and section 9801(f)(3)(B)(i) of the 

Internal Revenue Code (Code). 

Section 311(b)(1)(D) of CHIPRA 

provides that the Departments of Labor 

and Health and Human Services shall 

develop initial model notices as 

provided under ERISA section 

701(f)(3)(B)(i)(II) and the Department of 

Labor shall provide such notices to 

employers by February 4, 2010, which 

is one year after the enactment of 

CHIPRA. 

Section 104 of the Health Insurance 

Portability and Accountability Act of 

1996 (HIPAA) requires the Departments 

of Labor, the Treasury, and Health and 

Human Services (the Departments) to 

ensure that guidance under the health 

coverage provisions of Part 7 of the 

ERISA, Title XXVII of the PHS Act, and 

Chapter 100 of the Internal Revenue 

Code,1 and issued by the Departments 

that relates to the same matter, be 

administered so as to have the same 

effect at all times. 

In accordance with these 

requirements, this document has been 

developed in coordination with the 

Departments of Health and Human 

Services and the Treasury, and in 

consultation with State Medicaid and 

CHIP Agencies. 

III. Background 

Under ERISA section 701(f)(3)(B)(i)(I), 

PHS Act section 2701(f)(3)(B)(i)(I), and 

section 9801(f)(3)(B)(i)(I) of the Code, as 

added by CHIPRA, an employer that 

maintains a group health plan in a State 

that provides medical assistance under 

a State Medicaid plan under title XIX of 

the Social Security Act (SSA), or child 

health assistance under a State child 

health plan under title XXI of the SSA, 

in the form of premium assistance for 

the purchase of coverage under a group 

health plan, is required to make certain 

disclosures. Specifically, the employer 

is required to notify each employee of 

potential opportunities currently 

available in the State in which the 

employee resides for premium 

assistance under Medicaid and CHIP for 

health coverage of the employee or the 

employee’s dependents. These notices 

are referred to in this document as 

‘‘Employer CHIP Notices’’. 

ERISA section 701(f)(3)(B)(i)(II) 

requires the Department to provide 

employers with model language for the 

Employer CHIP Notices to enable them 

to timely comply with this requirement. 

The model is required to include 

information on how an employee may 

contact the State in which the employee 

resides for additional information 

regarding potential opportunities for 

premium assistance, including how to 

apply for such assistance. 

Section 311(b)(1)(D) of CHIPRA 

provides that the Departments of Labor 

and Health and Human Services shall 

develop the initial model notices under 

ERISA section 701(f)(3)(B)(i)(II), and the 

Department of Labor shall provide such 

notices to employers, by February 4, 

2010. Moreover, each employer is 

required to provide the initial annual 

notices to such employer’s employees 

beginning with the first plan year that 

begins after the date on which the initial 

model notices are first issued. 

ERISA section 701(f)(3)(B)(i)(III), PHS 

Act section 2701(f)(3)(B)(i)(II), and Code 

section 9801(f)(3)(B)(i)(II) provide that 

an employer may provide the Employer 

CHIP Notice concurrent with the 

furnishing of materials notifying the 

employee of health plan eligibility, 

concurrent with materials provided to 

the employee in connection with open 

season (or other coverage election 

process under the plan), or concurrent 

with the furnishing of the Summary 

Plan Description (SPD) provided under 

ERISA section 104(b). 

IV. Compliance With the Employer 

CHIP Notice and Model Language 

A. Employers Subject to the Employer 

CHIP Notice Requirement 

For purposes of the Employer CHIP 

Notice requirement, an employer 

providing benefits (directly or through 

insurance, reimbursement, or otherwise) 

for medical care in a State is considered 

to maintain a group health plan in that 

State. If that State provides medical 

assistance under a State Medicaid plan, 

or child health assistance under a State 

child health plan, in the form of 

premium assistance for the purchase of 

group health plan coverage, the 

employer is required to provide the 

Employer CHIP Notice. The Department 

of Health and Human Services, in 

consultation with State Medicaid and 

CHIP offices, has informed the 

Department that, as of January 22, 2010, 

the following States offer one or more 

programs that meet this standard: 

• Alabama, 

• Alaska, 

• Arizona, 

• Arkansas, 

• California, 

• Colorado, 

• Florida, 

• Georgia, 

• Idaho, 

• Indiana, 

• Iowa, 

• Kansas, 

• Kentucky, 

• Louisiana, 

• Maine, 

• Massachusetts, 

• Minnesota, 

• Missouri, 

• Montana, 

• Nebraska, 

• Nevada, 

• New Hampshire, 

• New Jersey, 

• New Mexico, 

• New York, 

• North Carolina, 

• North Dakota, 

• Oklahoma, 

• Oregon, 

• Pennsylvania, 

• Rhode Island, 

• South Carolina, 

• Texas, 

• Utah, 

• Vermont, 

• Virginia, 

• Washington, 

• West Virginia, 

• Wisconsin, and 

• Wyoming. 

Accordingly, if a group health plan 

provides benefits for medical care 

directly (such as through a health 

maintenance organization); or through 

insurance, reimbursement or otherwise 

to participants, beneficiaries, or 

providers in one of these States, the 

plan is required to provide the 

Employer CHIP Notice, regardless of the 

employer’s location or principal place of 

business (or the location or principal 

place of business of the group health 

plan, its administrator, its insurer, or 

any other service provider affiliated 

with the employer or the plan). This 

principle is illustrated by the following 

example: 

Example 1. (i) Facts. An employer in the 

District of Columbia sponsors a group health 

plan that provides reimbursement for 

medical care to plan participants or 

beneficiaries residing in the District of 

Columbia, Virginia, Maryland, West Virginia, 

Delaware, and Pennsylvania. 

(ii) Conclusion. In this Example 1, the plan 

is considered maintained in all six States. 

Because at least one of these States offers a 

premium assistance program, the employer is 

subject to the Employer CHIP Notice 

requirement. 


srobinson on DSKHWCL6B1PROD with NOTICES
5810 Federal Register / Vol. 75, No. 23 / Thursday, February 4, 2010 / Notices 

B. Employees Entitled to Notice 

An Employer CHIP Notice must 

inform each employee, regardless of 

enrollment status, of potential 

opportunities for premium assistance in 

the State in which the employee resides. 

The State is which the employee resides 

may or may not be the same as the State 

in which the employer, the employer’s 

principal place of business, the health 

plan, its insurer, or other service 

providers are located. This principle is 

illustrated by the following example: 

Example 2. (i) Facts. Same facts as 

Example 1, above. 

(ii) Conclusion. In this Example 2, 

employees residing in Virginia, West 

Virginia, and Pennsylvania are entitled to 

receive the notice because those three States 

offer premium assistance programs. Of 

course, the employer may send the notice to 

all employees if the employer chooses (for 

example, if it is administratively easier to 

send the notice to all than to distinguish 

between employees based on residency). 

C. Form and Content of Notice 

The Model Employer CHIP Notice 

was designed as a template to cover an 

array of situations where employees 

may be entitled to notice and may reside 

(or their families may reside) in States 

across the nation. Employers may use 

the model template as a national notice 

to fulfill their employer notice 

disclosure obligation under ERISA 

section 701(f)(3)(B)(i), and the parallel 

provisions of section 2701(f)(3)(B)(i) of 

the PHS Act and section 9801(f)(3)(B)(i) 

of the Code. The notice is required to be 

provided automatically, free of charge. 

In consultation with State Medicaid 

and CHIP offices, some States suggested 

significant modifications to the template 

and more detailed descriptions of their 

own State programs. Of course, the 

Model Employer CHIP Notice is just a 

model and States may wish to include 

additional information on their Web 

sites and in their own compliance 

assistance materials that would 

encourage further disclosure of any 

individual State premium assistance 

program. Nonetheless, because 

employees (and their families) may 

reside in different States than their 

employer, its principal place of 

business, their health plan, its insurer, 

or its other service providers that may 

distribute the notice on behalf of the 

employer, the approach of the Model 

Employer CHIP Notice is to provide a 

very brief description of premium 

assistance and rely on State contact 

information for State-specific program 

descriptions. An employer which is not 

facing multi-State complexities and who 

wants to provide more comprehensive 

State-specific information to its 

workforce may modify the Model 

Employer CHIP Notice to its employees. 

However, employers should be mindful 

of the requirement to include at least the 

minimum relevant State contact 

information for any employee residing 

in a State with premium assistance. 

The employer CHIP disclosure 

requirement in ERISA, the PHS Act, and 

the Code requires that the notice inform 

employees of potential opportunities for 

premium assistance ‘‘currently 

available.’’ CHIPRA section 311(b)(1)(D) 

requires the Department of Labor to 

provide ‘‘initial’’ model notices within 

one year of CHIPRA’s enactment. 

Employers are required to provide 

‘‘initial annual notices beginning with 

the first plan year after the date on 

which such initial model notices are 

first issued.’’ The Department, working 

with the Departments of Health and 

Human Services and the Treasury, and 

the States, intends to update its Web site 

annually to reflect any changes in the 

number of States offering premium 

assistance programs (or the contact 

information for those States), to help 

enable employers to meet their CHIP 

disclosure requirements. 

D. Timing and Delivery of the Notice 

Employers are required to provide 

these notices by the date that is the later 

of (1) the first day of the first plan year 

after February 4, 2010; or (2) May 1, 

2010. Accordingly, for plan years 

beginning between from February 4, 

2010 through April 30, 2010, the 

Employer CHIP notice must be provided 

by May 1, 2010. For employers whose 

next plan year begins on or after May 1, 

2010, the Employer CHIP notice must be 

provided by the first day of the next 

plan year (January 1, 2011 for calendar 

year plans). 

The Employer CHIP notice is not 

required to be provided in a separate 

mailing. Plans may combine 

information to reduce administrative 

costs, if the other requirements of this 

Notice are met. Thus, the Employer 

CHIP Notice may be furnished 

concurrent with enrollment packets, 

open season materials, or the plan SPD, 

provided that (1) such materials are 

provided no later than the date 

determined above, (2) such materials are 

provided to all employees entitled to 

receive the Employer CHIP Notice, and 

(3) the Employer CHIP Notice appears 

separately and in a manner which 

ensures that an employee who may be 

eligible for premium assistance could 

reasonably be expected to appreciate its 

significance. 

Accordingly, an employer may 

provide the Employer CHIP notice 

concurrent with other materials 

(including, for example, enrollment 

packets, open season materials, or the 

plan SPD) that may be provided in 

advance of the upcoming plan year. 

This principle is illustrated by the 

following example: 

Example 3. (i) Facts. An employer 

maintains a group health plan with a plan 

year beginning January 1, 2011. The plan has 

an annual open enrollment season that 

occurs from October 15, 2010 through 

November 30, 2010 with coverage effective 

January 1, 2011. Open season packets are to 

be distributed on October 1, 2010 to all 

employees of the employer. 

(ii) Conclusion. In this Example 3, the 

employer may distribute the Employer CHIP 

notice as a separate, prominent document in 

the open season packet on October 1, 2010 

and the notice is required to be provided no 

later than January 1, 2011. 

The notice must be provided in 

writing in a manner calculated to be 

understood by the average employee. It 

may be provided by first-class mail. 

Alternatively, it may be provided 

electronically to the extent the criteria 

of the Department’s electronic 

disclosure safe harbor at 29 CFR 

2520.104b–1(c) are satisfied. 

CHIPRA requires the notice to be 

provided annually. The Department 

expects to update its Web site with the 

list of States that offer premium 

assistance programs and provide other 

additional information annually to help 

enable employers to meet their 

Employer CHIP notice obligations. 

Comments regarding the Employer CHIP 

notice requirement are invited. 

V. Model Employer CHIP Notice 

The model Employer CHIP Notice is 

available in modifiable, electronic form 

on the Department’s Web site: http:// 

www.dol.gov/ebsa. 

VI. Additional Information 

In addition to the Employer CHIP 

Notice requirement, CHIPRA also 

provides that, in order for States to 

evaluate an employment-based plan to 

determine whether premium assistance 

is a cost effective way to provide 

medical or child health assistance to an 

individual, group health plans are 

required to provide, upon request, 

information about their benefits to State 

Medicaid or CHIP programs. The 

Departments, in conjunction with an 

advisory committee, are separately 

developing a model coverage 

coordination disclosure form that will 

be issued in the future. States may begin 

requesting this information from plans 

beginning with the first plan year after 

this model form is issued. 

Group health plans and group health 

insurance issuers must also offer new 

special enrollment opportunities after 


srobinson on DSKHWCL6B1PROD with NOTICES
Federal Register / Vol. 75, No. 23 / Thursday, February 4, 2010 / Notices 5811 

CHIPRA. Effective April 1, 2009, plans 

and issuers are required to permit 

employees and dependents who are 

eligible for, but not enrolled in, a group 

health plan to enroll in the plan upon: 

(1) Losing eligibility for coverage under 

a State Medicaid or CHIP program, or (2) 

becoming eligible for State premium 

assistance under Medicaid or CHIP. The 

employee or dependent must request 

coverage within 60 days of being 

terminated from Medicaid or CHIP 

coverage or within 60 days of being 

determined to be eligible for premium 

assistance. Information is available on 

the Department’s Web site at http:// 

www.dol.gov/ebsa regarding special 

enrollment. Information is also available 

on the Department of Health and 

Human Service’s Web site at http:// 

www.cms.hhs.gov. 

Individuals should contact their 

State’s Medicaid or CHIP program to 

determine if they are eligible for 

Medicaid or CHIP, and to see if their 

State will subsidize group health plan 

premiums. Information is also available 

by calling 1–877–KIDS NOW or on the 

Internet at http:// 

www.insurekidsnow.gov. If they are 

eligible for premium assistance, 

individuals must contact their plan 

administrator or employer to take 

advantage of the new special enrollment 

opportunity and enroll in the group 

health plan. 

Individuals needing assistance or 

with questions about the application of 

these provisions to their employmentbased group health plan can call toll 

free 1.866.444.3272 (EBSA) to speak to 

a Benefits Advisor. Information is also 

available on EBSA’s Web site at 

http://www.dol.gov/ebsa. 

VII. Paperwork Reduction Act 

Statement 

According to the Paperwork 

Reduction Act of 1995 (Pub. L. 104–13) 

(PRA), no persons are required to 

respond to a collection of information 

unless such collection displays a valid 

OMB control number. The Department 

notes that a Federal agency cannot 

conduct or sponsor a collection of 

information unless it is approved by 

OMB under the PRA, and displays a 

currently valid OMB control number, 

and the public is not required to 

respond to a collection of information 

unless it displays a currently valid OMB 

control number. See 44 U.S.C. 3507. 

Also, notwithstanding any other 

provisions of law, no person shall be 

subject to penalty for failing to comply 

with a collection of information if the 

collection of information does not 

display a currently valid OMB control 

number. See 44 U.S.C. 3512. 

OMB has approved the model 

Employer CHIPRA notice information 

collection request pursuant to the 

emergency review procedures under 5 

CFR 1320.13. The public reporting 

burden for this collection of information 

is estimated to average approximately 

30 seconds per respondent. Interested 

parties are encouraged to send 

comments regarding the burden 

estimate or any other aspect of this 

collection of information, including 

suggestions for reducing this burden, to 

the U.S. Department of Labor, Office of 

the Chief Information Officer, Attention: 

Departmental Clearance Officer, 200 

Constitution Avenue, NW., Room 

N–1301, Washington, DC 20210 or email DOL_PRA_PUBLIC@dol.gov and 

reference the OMB Control Number 

1210–0137. 

VIII. Statutory Authority 

Authority: 29 U.S.C. 1027, 1059, 1135, 

1161–1169, 1181–1183, 1181 note, 1185, 

1185a, 1185b, 1191, 1191a, 1191b, and 1191c; 

sec. 101(g), Public Law 104–191, 110 Stat. 

1936; sec. 401(b), Public Law 105–200, 112 

Stat. 645 (42 U.S.C. 651 note); sec. 101(f), 

Public Law 110–233, 122 Stat. 881; sec. 

512(d), Public Law 110–343, 122 Stat. 3765; 

Public Law 110–460, 122 Stat. 5123; Public 

Law 111–3, 123 Stat. 8; Secretary of Labor’s 

Order 6–2009, 74 FR 21524 (May 7, 2009). 

Signed at Washington, DC, this 1st day of 

February 2010. 

Phyllis C. Borzi, 

Assistant Secretary, Employee Benefits 

Security Administration. 

[FR Doc. 2010–2409 Filed 2–3–10; 8:45 am] 

BILLING CODE 4510–29–P 

NATIONAL AERONAUTICS AND 

SPACE ADMINISTRATION 

[Notice: (10–016)] 

Notice of Information Collection 

AGENCY: National Aeronautics and 

Space Administration (NASA). 

ACTION: Notice of information collection. 

SUMMARY: The National Aeronautics and 

Space Administration, as part of its 

continuing effort to reduce paperwork 

and respondent burden, invites the 

general public and other Federal 

agencies to take this opportunity to 

comment on proposed and/or 

continuing information collections, as 

required by the Paperwork Reduction 

Act of 1995 (Pub. L. 104–13, 44 U.S.C. 

3506(c)(2)(A)). 

DATES: All comments should be 

submitted within 60 calendar days from 

the date of this publication. 

ADDRESSES: All comments should be 

addressed to Brenda Maxwell, National 

Aeronautics and Space Administration, 

Washington, DC 20546–0001. 

FOR FURTHER INFORMATION CONTACT: 

Requests for additional information or 

copies of the information collection 

instrument(s) and instructions should 

be directed to Brenda Maxwell, NASA 

PRA Officer, NASA Headquarters, 300 E 

Street, SW., JF000, Washington, DC 

20546, (202) 358–4616, 

Brenda.Maxwell@nasa.gov. 

SUPPLEMENTARY INFORMATION: 

I. Abstract 

Information is needed to guide 

implementation of GLOBE (Global 

Learning and Observations to Benefit 

the Environment) based on feedback 

from participating teachers, students, 

and partners in order to help meet the 

Program’s goal of improving student 

achievement in mathematics and 

science. 

II. Method of Collection 

The GLOBE Partner survey is Webbased on-line instrument. The survey 

gathers data on all activities related to 

GLOBE implementation for the year 

prior to administration of the survey. 

III. Data 

Title: GLOBE Program Evaluation. 

OMB Number: 2700–0114. 

Type of review: Extension of currently 

approved collection. 

Affected Public: State, Local, or Tribal 

Government; individuals or households; 

and not-for-profit institutions. 

Number of Respondents: 258. 

Responses per Respondent: 1. 

Annual Responses: 258 

Hours per Request: 2. 

Annual Burden Hours: 516. 

IV. Request for Comments 

Comments are invited on: (1) Whether 

the proposed collection of information 

is necessary for the proper performance 

of the functions of NASA, including 

whether the information collected has 

practical utility; (2) the accuracy of 

NASA’s estimate of the burden 

(including hours and cost) of the 

proposed collection of information; (3) 

ways to enhance the quality, utility, and 

clarity of the information to be 

collected; and (4) ways to minimize the 

burden of the collection of information 

on respondents, including automated 

collection techniques or the use of other 

forms of information technology. 

Comments submitted in response to 

this notice will be summarized and 

included in the request for OMB 

approval of this information collection. 


srobinson on DSKHWCL6B1PROD with NOTICES