Agency Recordkeeping/Reporting Requirements Under Review by the Office of Management and Budget (OMB)

DEPARTMENT OF LABOR

Office of the Secretary

Agency Recordkeeping/Reporting Requirements Under Review by the

Office of Management and Budget (OMB)

June 15, 1995.

The Department of Labor has submitted the following public

information collection requests (ICRs) to the Office of Management and

Budget (OMB) for review and clearance under the Paperwork Reduction Act

(44 U.S.C. Chapter 35) of 1980, as amended (P.L. 96-511). Copies may be

obtained by calling the Department of Labor Acting Departmental

Clearance Officer, Theresa M. O'Malley ({202} 219-5095). Comments and

questions about the ICRs listed below should be directed to Ms.

O'Malley, Office of Information Resources Management Policy, U.S.

Department of Labor, 200 Constitution Avenue, NW., Room N-1301,

Washington, DC 20210. Comments should also be sent to the Office of

Information and Regulatory Affairs, Attn: OMB Desk Officer for (BLS/DM/

ESA/ETA/OAW/MSHA/OSHA/PWBA/VETS), Office of Management and Budget, Room

10325, Washington, DC 20503 ({202}) 395-7316).

Individuals who use a telecommunications device for the deaf (TTY/

TDD) may call {202} 219-4720 between 1:00 p.m. and 4:00 p.m. Eastern

time, Monday through Friday.

Type of Review: Revision

Agency: Bureau of Labor Statistics

Title: National Longitudinal Survey of Youth 79

OMB Number: 1220-0109

Agency number: NORC-4531

Frequency: Biennially

Affected Public: Individuals or households

Number of Respondents: 8,850

Estimated Time per Respondent: 100 minutes

Total Burden Hours: 14,750

Description: The information provided in this survey will be used by

the Department of Labor and other government agencies to help

understand and explain the employment, unemployment, and related

problems faced by young men and women in this age group.

Type of Review: Revision

Agency: Employment Standards Administration

Title: Application for a Farm Labor Contractor Employee Certificate of

Registration

OMB Number: 1215-0037

Agency number: WH-512 MIS

Frequency: On occasion

Affected Public: Individuals or households; Business or other for-

profit; Farms

Number of Respondents: 2,700

Estimated Time per Respondent: 30 minutes

Total Burden Hours: 1,350

Description: The Migrant Seasonal Agricultural Worker Protection Act

provides that no individual may perform farm labor contracting

activities without a certificate of registration. Form WH-512 MIS is an

application form which provides the Department of Labor with the

information necessary to issue a certificate specifying the farm labor

contracting activities authorized.

Type of Review: Extension

Agency: Employment Standards Administration

Title: Medical Travel Refund Request

OMB Number: 1215-0054

Agency Number: CM-957

Frequency: On occasion

Affected Public: Individuals or households; Business or other for-

profit

Number of Respondents: 12,000

Estimated Time Per Respondent: 10 minutes

Total Burden Hours: 2,000

Description: This form is used by coal miners requesting reimbursement

for out-of-pocket expenses incurred when traveling to medical providers

for black lung diagnostic testing or treatment of their black lung

disease.

[[Page 32342]] Type of Review: Extension

Agency: Employment Standards Administration

Title: Operator Controversion--CM-970; Operator Response--CM-970a

OMB Number: 1215-0058

Agency Number: CM-970; CM-970a

Frequency: On occasion

Affected Public: Business or other for-profit

Number of Respondents: 3,500

Estimated Time Per Respondent: 15 minutes

Total Burden Hours: 1,750

Description: The CM-970 and the CM-970a are used by most coal mine

operators to controvert an initial finding or potential liability for

payment of black lung benefits under the Act.

Type of Review: Extension

Agency: Employment Standards Administration

Title: Request for State or Federal Workers' Compensation Information

OMB Number: 1215-0060

Agency Number: CM-905

Frequency: On occasion

Affected Public: Federal Government; State, Local or Tribal Government

Number of Respondents: 4,440

Estimated Time Per Respondent: 15 minutes

Total Burden Hours: 1,100

Description: The Federal Mine Safety and Health Act of 1977, as

amended, 30 U.S.C. 922 and 20 CFR 725.535 direct that Department of

Labor benefit payments to a beneficiary for any month be reduced by any

other payments of State of Federal benefits for workers' compensation

due to pneumoconiosis. To ensure compliance with this mandate, the

Division of Coal Mine Workers Compensation (DCMWC) must collect

information regarding the status of any State or Federal workers'

compensation claim, including date of payments, weekly or lump sum

amounts paid, and other fees or expenses paid out of this award. The

information is used by the DCMWC in determining the amounts of black

lung benefits paid to beneficiaries.

Type of Review: Extension

Agency: Employment Standards Administration

Title: Survivor's Notification of Beneficiary's Death

OMB Number: 1215-0087

Agency Number: CM-1089

Frequency: On occasion

Affected Public: Individuals or households

Number of Respondents: 2,100

Estimated Time Per Respondent: 8 minutes

Total Burden Hours: 280

Description: The CM-1089 is used to gather information from a

beneficiary's survivor to ensure that benefits due on behalf of a

deceased miner are accurate for continuation of benefits.

Type of Review: Extension

Agency: Employment Standards Administration

Title: Survivor's Notification of Beneficiary's Death

OMB Number: 1215-0116

Agency Number: CA-721, CA-722

Frequency: On occasion

Affected Public: Individuals or households; Business or other for-

profit; State, local or Tribal Government

------------------------------------------------------------------------

Estimated

time per

Form Respondents respondent

minutes

------------------------------------------------------------------------

CA-721......................................... 16 60

CA-722......................................... 47 90

------------------------------------------------------------------------

Total Burden Hours: 87

Description: These forms are used for filing claims for compensation

for injury and death to non-Federal law enforcement officers under the

provisions of U.S.C. 8191, etc. seq. The forms provide the basic

information needed to process the claims made for injury or death.

Type of Review: Extension

Agency: Employment Standards Administration

Title: Waiver of Child Labor Provisions for Agricultural employment of

10 and 11 Year Old Minor in Hand Harvesting of Short Season Crops

OMB Number: 1215-0120

Frequency: On occasion

Affected Public: Individuals or households; Farms

Number of Respondents: 1

Estimated Time Per Respondent: 4 hours

Total Burden Hours: 4

Description: Agricultural employers must supply certain information to

the Department of Labor when applying for a waiver of the child labor

provisions to employ 10 and 11 year old minors in hand harvesting of

short season crops. Employers granted waivers are required to maintain

certain records.

Type of Review: Extension

Agency: Employment Standards Administration

Title: Maintenance of Receipt for Benefits Paid by a Coal Mine Operator

OMB Number: 1215-0124

Agency: CM-200

Frequency: Recordkeeping

Affected Public: Business or other for-profit

Number of Respondents: 150

Estimated Time Per Respondent: 1 hour

Total Burden Hours: 150

Description: Insurance carriers and self-insured coal mine operators

who make benefit payments to black lung beneficiaries are required to

maintain receipts for black lung benefit payments for five years after

the date on which the receipt was executive in order to verify payment

of black lung benefits.

Type of Review: Revision

Agency: Employment Standards Administration

Title: Labor Standards for Federal Service Contracts

OMB Number: 1215-0150

Frequency: On occasion

Affected Public: Business or other for-profit; Federal Government

Number of Respondents: 55,567

------------------------------------------------------------------------

Estimated time

Type Respondents per respondent

------------------------------------------------------------------------

Vacation benefit seniority list.......... 53,267 1 hour.

Conformance record....................... 300 30 minutes.

Collective bargaining agreements......... 2,000 5 minutes.

------------------------------------------------------------------------

Total Burden Hours: 53,584

Description: This information collection is in accordance with the

provisions of 29 CFR part 4 for recordkeeping and incidental reporting

requirements in Service Contract Act Regulations applicable to

employers performing on service contracts with the Federal government.

Type of Review: Extension

Agency: Employment Standards Administration

Title: Rehabilitation Maintenance Certificate

OMB Number: 1215-0161

Agency number: OWCP 17

Frequency: On occasion

Affected Public: Individuals or households; Business or other for-

profit; Not-for-profit institutions

Number of Respondents: 1,300

Estimated Time per Respondent: 10 minutes

Total Burden Hours: 15,600

Description: The Office of Workers Compensation Program (OWCP 17)

serves as a bill submitted by the injured worker to OWCP requesting

reimbursement of expenses incurred due to participation in an approved

rehabilitation effort for the preceding four week period or fraction

thereof.

[[Page 32343]] Type of Review: Extension

Agency: Employment Standards Administration

Title: Application for Approval of a Representative's Fee in a Black

Lung Proceeding Conducted by the Department of Labor

OMB Number: 12515-0171

Agency number: CM-972

Frequency: On occasion

Affected Public: Business or other for-profit

Number of Respondents: 1,600

Estimated Time per Respondent: 42 minutes

Total Burden Hours: 1,120

Description: Specific requirements are set forth in 20 CFR 725.365 and

725.366 for the items of information that must be included on

representative fee applications in order for the representative to be

paid. The CM-972 is designed to collect this information.

Type of Review: Reinstatement

Agency: Employment and Training Administration

Title: Internal Fraud Activities

OMB Number: 1215-0187

Agency number: ETA 9000

Frequency: Annual

Affected Public: Federal Government; State, Local or Tribal Government

Number of Respondents: 53

Estimated Time per Respondent: 3 hours

Total Burden Hours: 159

Description: Form ETA 9000 is the State Employment Security Agency's

(SESA) Employment and Training Administration's (ETA) sole data

collection instrument to identifying continuing activity involving

internal fraud and assessing fraud prevention effectiveness. Resulting

analysis will be communicated to SESAs to enhance management efforts in

controlling false representation and fraud. Negative trends could

result in ETA requesting Office of the Inspector General audits.

Type of Review: Revision

Agency: Employment and Training Administration

Title: Attestation by Employers Using Alien Crewmembers for Longshore

Activities in U.S. Ports

OMB Number: 1205-0309

Agency number: ETA 9033

Frequency: As needed

Affected Public: Individuals or households; Business or other for-

profit; Not-for-profit institutions; Federal Government; State, Local

or Tribal Government

Number of Respondents: 500

Estimated Time per Respondent: 4 hours

Total Burden Hours: 2,000

Description: The information provided on this form by employers seeking

to use alien crewmembers to perform longshore work at U.S. ports will

permit the Department of Labor to meet Federal responsibilities for

program administration, management and oversight.

Type of Review: Extension

Agency: Mine Safety Health Administration

Title: Training Plan Regulations (30 CFR 48.3 and 48.23)

OMB Number: 1219-0009

Frequency: On occasion

Affected Public: Business or other for-profit

Number of Respondents: 1,300

Estimated Time per Respondent: 8 hours

Total Burden Hours: 10,400

Description: Requires mine operators to have a Mine Safety and Health

Administration approved plan containing programs for training new

miners, training newly-employed experienced miners, training miners for

new tasks, annual refresher training, and hazard training.

Type of Review: Extension

Agency: Departmental Management, Office of the Solicitor

Title: Equal Access to Justice Act

OMB Number: 1225-0013

Frequency: On occasion

Affected Public: Individuals or households; Business or other for-

profit; Not-for-profit institutions; Federal Government; State, Local

or Tribal Government

Number of Respondents: 10

Estimated Time per Respondent: 5 hours

Total Burden Hours: 50

Description: The Equal Access to Justice Act provides for payment of

fees and expenses to eligible parties who have prevailed against the

Department of Labor in certain administrative proceedings. In order to

obtain an aware, the statute and regulations require the filing of an

application.

Theresa M. O'Malley,

Acting Departmental Clearance Officer.

[FR Doc. 95-15213 Filed 6-20-95; 8:45 am

BILLING CODE 4510-27-M