REPORT IS A PLAN SUBMITTED BY AN
INJURED WORKER AND REHABILITATION COUNSELOR TO OWCP FOR AWARD OF
PAYMENT FOR REHABILITATIVE SERVICES AND IS REQUIRED FOR THE
DETERMINATION OF ELIGIBILITY FOR PAYMENT FOR SUCH SERVICES UNDER
SECTION 8104(A) OF THE FEDERAL EMPLOYEES' COMPENSATION ACT AND
SECTION 39(C) OF THE LONGSHORE AND HARBOR WORKERS' COMPENSATION
ACT.
On behalf of this Federal agency, I certify that
the collection of information encompassed by this request complies
with 5 CFR 1320.9 and the related provisions of 5 CFR
1320.8(b)(3).
The following is a summary of the topics, regarding
the proposed collection of information, that the certification
covers:
(i) Why the information is being collected;
(ii) Use of information;
(iii) Burden estimate;
(iv) Nature of response (voluntary, required for a
benefit, or mandatory);
(v) Nature and extent of confidentiality; and
(vi) Need to display currently valid OMB control
number;
If you are unable to certify compliance with any of
these provisions, identify the item by leaving the box unchecked
and explain the reason in the Supporting Statement.