[Federal Register Volume 78, Number 210 (Wednesday, October 30, 2013)]
[Notices]
[Pages 64979-64980]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2013-25630]


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DEPARTMENT OF LABOR

Office of the Secretary


Agency Information Collection Activities; Submission for OMB 
Review; Comment Request; Notice of Law Enforcement Officer's Injury or 
Occupational Disease and Notice of Law Enforcement Officer's Death

ACTION: Notice.

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SUMMARY: The Department of Labor (DOL) is submitting the Office of 
Workers' Compensation Programs (OWCP) sponsored information collection 
request (ICR) revision titled, ``Notice of Law Enforcement Officer's 
Injury or Occupational Disease and Notice of Law Enforcement Officer's 
Death,'' to the Office of Management and Budget (OMB) for review and 
approval for use in accordance with the Paperwork Reduction Act (PRA) 
of 1995 (44 U.S.C. 3501 et seq.).

DATES: Submit comments on or before November 29, 2013.

ADDRESSES: A copy of this ICR with applicable supporting documentation; 
including a description of the likely respondents, proposed frequency 
of response, and estimated total burden may be obtained free of charge 
from the RegInfo.gov Web site at http://www.reginfo.gov/public/do/PRAViewICR?ref_nbr=201306-1240-006

[[Page 64980]]

(this link will only become active on the day following publication of 
this notice) or by contacting Michel Smyth by telephone at 202-693-4129 
(this is not a toll-free number) or sending an email to [email protected].
    Submit comments about this request to the Office of Information and 
Regulatory Affairs, Attn: OMB Desk Officer for DOL-OWCP, Office of 
Management and Budget, Room 10235, 725 17th Street NW., Washington, DC 
20503, Fax: 202-395-6881 (this is not a toll-free number), email: 
[email protected]. Commenters are encouraged, but not 
required, to send a courtesy copy of any comments to the U.S. 
Department of Labor--OASAM, Office of the Chief Information Officer, 
Attn: Information Management Program, Room N1301, 200 Constitution 
Avenue NW., Washington, DC 20210, email: [email protected].

FOR FURTHER INFORMATION CONTACT: Michel Smyth by telephone at 202-693-
4129 (this is not a toll-free number) or by email at [email protected].

    Authority:  44 U.S.C. 3507(a)(1)(D).


SUPPLEMENTARY INFORMATION: As appropriate, a respondent files a Notice 
of Law Enforcement Officer's Injury or Occupational Disease, Form CA-
721, or Notice of Law Enforcement Officer's Death, Form (CA-722), when 
seeking Federal Employees' Compensation Act (5 U.S.C. 8191 et seq.) 
benefits for a non-Federal law enforcement officer's injury, 
occupational illness, or death. The forms provide the OWCP with basic 
information needed to process a claim made for injury, illness, or 
death. This ICR has been classified as a revision, because--in 
accordance with Department of the Treasury requirements for all Federal 
benefits payments to be made electronically--Forms CA-721 and CA-722 
have been changed to include space and instructions for claimants to 
provide direct deposit information. In addition, rather than requesting 
the claimant's signature, Form CA-722 has been revised to request the 
signature of the person filing the claim. Both forms have also been 
revised to include an accommodation statement informing claimants with 
mental or physical limitations to contact the OWCP, Division of Federal 
Employees' Compensation if they need further assistance with the claims 
process.
    This information collection is subject to the PRA. A Federal agency 
generally cannot conduct or sponsor a collection of information, and 
the public is generally not required to respond to an information 
collection, unless it is approved by the OMB under the PRA and displays 
a currently valid OMB Control Number. In addition, notwithstanding any 
other provisions of law, no person shall generally be subject to 
penalty for failing to comply with a collection of information that 
does not display a valid Control Number. See 5 CFR 1320.5(a) and 
1320.6. The DOL obtains OMB approval for this information collection 
under Control Number 1240-0022. The current approval is scheduled to 
expire on October 31, 2013; however, it should be noted that existing 
information collection requirements submitted to the OMB receive a 
month-to-month extension while they undergo review. New requirements 
would only take effect upon OMB approval. For additional substantive 
information about this ICR, see the related notice published in the 
Federal Register on July 5, 2013 (78 FR 40513).
    Interested parties are encouraged to send comments to the OMB, 
Office of Information and Regulatory Affairs at the address shown in 
the ADDRESSES section within 30 days of publication of this notice in 
the Federal Register. In order to help ensure appropriate 
consideration, comments should mention OMB Control Number 1240-0022. 
The OMB 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 submission of responses.
    Agency: DOL-OWCP.
    Title of Collection: Notice of Law Enforcement Officer's Injury or 
Occupational Disease and Notice of Law Enforcement Officer's Death.
    OMB Control Number: 1240-0022.
    Affected Public: Individuals or Households.
    Total Estimated Number of Respondents: 10.
    Total Estimated Number of Responses: 10.
    Total Estimated Annual Burden Hours: 14.
    Total Estimated Annual Other Costs Burden: $5.

    Dated: October 24, 2013.
Michel Smyth,
Departmental Clearance Officer.
[FR Doc. 2013-25630 Filed 10-29-13; 8:45 am]
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