Application for Approval of a Representative's Fee in Black Lung Claim Proceedings Conducted by the U.S. Department of Labor

ICR 202304-1240-002

OMB: 1240-0011

Federal Form Document

ICR Details
1240-0011 202304-1240-002
Received in OIRA 202001-1240-001
DOL/OWCP
Application for Approval of a Representative's Fee in Black Lung Claim Proceedings Conducted by the U.S. Department of Labor
Revision of a currently approved collection   No
Regular 09/07/2023
  Requested Previously Approved
36 Months From Approved 10/31/2023
590 944
413 661
204 548

The purpose of the CM-972 is to collect pertinent data to determine if the representative's services and the amounts charged can be paid under the Black Lung Benefits Act.

US Code: 30 USC 932 Name of Law: Black Lung Benefits Act
   US Code: 30 USC 936 Name of Law: Black Lung Benefits Act
   US Code: 30 USC 901 Name of Law: Black Lung Benefits Act
  
None

Not associated with rulemaking

  88 FR 29697 05/08/2023
88 FR 61616 09/07/2023
No

  Total Request Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 590 944 0 -354 0 0
Annual Time Burden (Hours) 413 661 0 -248 0 0
Annual Cost Burden (Dollars) 204 548 0 -344 0 0
No
Yes
Miscellaneous Actions
The number of respondents decreased from 944 to 590. The number of respondents decreased due to a decreased number of attorney fee awards issued. Also more applications were submitted electronically.

$13,269
No
    Yes
    Yes
No
No
No
No
Marcela Meneses 304 420-1232 [email protected]

  No

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.
09/07/2023


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