[Federal Register Volume 82, Number 56 (Friday, March 24, 2017)]
[Notices]
[Pages 15093-15094]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2017-05898]
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DEPARTMENT OF STATE
[Public Notice: 9914]
30-Day Notice of Proposed Information Collection: Medical
Clearance Update
ACTION: Notice of request for public comment and submission to OMB of
proposed collection of information.
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SUMMARY: The Department of State has submitted the information
collection described below to the Office of Management and Budget (OMB)
for approval. In accordance with the Paperwork Reduction Act of 1995 we
are requesting comments on this collection from all interested
individuals and organizations. The purpose of this Notice is to allow
30 days for public comment.
DATES: Submit comments directly to the Office of Management and Budget
(OMB) up to April 24, 2017.
ADDRESSES: Direct comments to the Department of State Desk Officer in
the Office of Information and Regulatory Affairs at the Office of
Management and Budget (OMB). You may submit comments by the following
methods:
Email: [email protected]. You must include the
DS form number, information collection title, and the OMB control
number in the subject line of your message.
Fax: 202-395-5806. Attention: Desk Officer for Department
of State.
FOR FURTHER INFORMATION CONTACT: Direct requests for additional
information regarding the collection listed in this notice, including
requests for copies of the proposed collection instrument and
supporting documents, to Joan F. Grew, who may be reached on 703-875-
5412 or at [email protected].
SUPPLEMENTARY INFORMATION: Title of Information Collection:
Medical Clearance Update.
OMB Control Number: 1405-0131.
Type of Request: Revision of a Currently Approved
Collection.
Originating Office: Bureau of Medical Services (MED).
Form Number: DS-3057.
Respondents: Foreign service officers, federal employees,
or family members.
[[Page 15094]]
Estimated Number of Respondents: 16,280.
Estimated Number of Responses: 16,280.
Average Time per Response: 30 minutes.
Total Estimated Burden Time: 8,140 hours.
Frequency: As needed.
Obligation to Respond: Requested to obtain benefits.
We are soliciting public comments to permit the Department to:
Evaluate whether the proposed information collection is
necessary for the proper functions of the Department.
Evaluate the accuracy of our estimate of the time and cost
burden for this proposed collection, including the validity of the
methodology and assumptions used.
Enhance the quality, utility, and clarity of the
information to be collected.
Minimize the reporting burden on those who are to respond,
including the use of automated collection techniques or other forms of
information technology.
Please note that comments submitted in response to this Notice are
public record. Before including any detailed personal information, you
should be aware that your comments as submitted, including your
personal information, will be available for public review.
Abstract of proposed collection: Form DS-3057 is designed to
collect medical information to provide medical providers with current
and adequate information to base decisions on whether a federal
employee and family members will have sufficient medical resources at a
diplomatic mission abroad to maintain the health and fitness of the
individual and family members.
Methodology: The information collected will be collected through
the use of an electronic forms engine or by hand written submission
using a pre-printed form.
Behzad Shahbazian,
Director of Clinical Services, Bureau of Medical Services, Department
of State.
[FR Doc. 2017-05898 Filed 3-23-17; 8:45 am]
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