INTERIOR/DOI-58, Employee Administrative Records

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Federal Register / Vol. 86, No. 170 / Tuesday, September 7, 2021 / Notices

HISTORY:

U.S. Department of the Interior, 1849 C
Street NW, Room 7112, Washington, DC
20240.
Instructions: All submissions received
must include the agency name and
docket number [DOI–2020–0019]. All
comments received will be posted
without change to http://
www.regulations.gov, including any
personal information provided.
Docket: For access to the docket to
read background documents or
comments received, go to http://
www.regulations.gov.

64 FR 18437 (April 14, 1999).
Teri Barnett,
Departmental Privacy Officer, Department of
the Interior.
[FR Doc. 2021–19170 Filed 9–3–21; 8:45 am]
BILLING CODE 4334–63–P

DEPARTMENT OF THE INTERIOR
Office of the Secretary
[DOI–2020–0019; 21XD4523WS,
DWSPF0000.XD0000, DS67010000,
DP67012]

Privacy Act of 1974; System of
Records
Office of the Secretary, Interior.
Notice of modified systems of

AGENCY:
ACTION:

records.

I. Background

Pursuant to the provisions of
the Privacy Act of 1974, as amended,
and the Office of Management and
Budget (OMB) Memorandum M–17–12,
Preparing for and Responding to a
Breach of Personally Identifiable
Information, the Department of the
Interior (DOI) is issuing a public notice
of its intent to modify Departmental and
bureau and office system of records
notices to add a new breach routine use
to ensure that the DOI can assist another
agency in responding to a confirmed or
suspected breach of personally
identifiable information, as appropriate.
DATES: This notice will be effective
upon publication. New or modified
routine uses will be effective October 7,
2021. Submit comments on or before
October 7, 2021.
ADDRESSES: You may send comments
identified by docket number [DOI–
2020–0019] by any of the following
methods:
• Federal eRulemaking Portal: http://
www.regulations.gov. Follow the
instructions for sending comments.
• Email: [email protected].
Include docket number [DOI–2020–
0019] in the subject line of the message.
• U.S. Mail or Hand Delivery: Teri
Barnett, Departmental Privacy Officer,
SUMMARY:

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Teri
Barnett, Departmental Privacy Officer,
U.S. Department of the Interior, 1849 C
Street NW, Room 7112, Washington, DC
20240, [email protected] or (202)
208–1605.
SUPPLEMENTARY INFORMATION:
FOR FURTHER INFORMATION CONTACT:

On May 22, 2007, OMB issued
Memorandum M–07–16, Safeguarding
Against and Responding to the Breach
of Personally Identifiable Information,
which required Federal agencies to
publish a routine use for their systems
of records specifically applying to the
disclosure of information in connection
with response and remedial efforts in
the event of a breach of personally
identifiable information. Several DOI
bureaus and offices published System of
Records Notices (SORNs) in the Federal
Register in 2008 to modify DOI bureau
and office systems of records by adding
a routine use in their ‘‘ROUTINE USES’’
section to address the limited disclosure
of records related to a suspected or
confirmed breach within DOI consistent
with OMB M–07–16. All new and
significantly modified SORNs published
by the DOI, or its bureaus and offices,
since that time included a breach
response routine use consistent with the
requirements outlined in OMB M–07–
16.
On January 3, 2017, OMB issued
Memorandum M–17–12, Preparing for
and Responding to a Breach of
Personally Identifiable Information,
which rescinded and replaced OMB M–
07–16. This memorandum requires

INTERIOR/BIA–2, Safety Records System ........................................
INTERIOR/BIA–04, Trust Asset and Accounting Management System (TAAMS).
INTERIOR/BIA–7, Tribal Enrollment Reporting and Payment System.
INTERIOR/BIA–8, Financial Assistance and Social Services—Case
Management System.
INTERIOR/BIA–10, Indian Housing Improvement Program ...............
INTERIOR/BIA–11, Indian Business Development Program (Grants)
INTERIOR/BIA–12, Indian Trust Land Mortgages .............................
INTERIOR/BIA–22, Native American Student Information System
(NASIS).
INTERIOR/BIA–26, Electrical Utility Management System ................

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agencies to publish two routine uses for
their systems of records specifically
applying to the disclosure of
information in connection with
response and remedial efforts in the
event of a breach of personally
identifiable information. Specifically,
OMB M–17–12 requires that agency
Senior Agency Officials for Privacy
ensure that their agency SORNs include
routine uses for the disclosure of
information necessary to respond to that
agency’s breach of PII. Additionally,
OMB M–17–12 requires that a breach
routine use be added to all agency
SORNs to ensure that agencies are able
to disclose records in their systems of
records to another Federal agency that
may reasonably be needed by that
agency to respond to a breach of PII.
DOI is issuing two separate notices in
the Federal Register to modify existing
DOI SORNs to satisfy the two breach
routine use requirements outlined in
OMB M–17–12.
DOI is publishing this notice to
modify the DOI SORNs identified below
to add a new breach routine use for the
limited disclosure of records that may
reasonably be needed by another agency
to respond to a breach. The DOI SORNs
for other DOI, bureau and office systems
of records that are omitted from this
notice have incorporated the new
breach routine use, are being rescinded,
or are being modified separately to
ensure continuity with their previous
notice publications. DOI is publishing a
notice elsewhere in the Federal Register
to revise DOI bureau and office SORNs
to include the required breach routine
use to comply with OMB M–17–12 for
the bureau and office systems of records
for the disclosure of information
necessary for DOI to respond to a breach
of PII.
This notice adds the new mandatory
breach routine use to the DOI systems
of records listed below to ensure that
the Department can assist another
agency in responding to a confirmed or
suspected breach, as appropriate,
pursuant to OMB M–17–12, Preparing
for and Responding to a Breach of
Personally Identifiable Information.

74 FR 26254 (June 1, 2009).
79 FR 68292 (November 14, 2014).
76 FR 59733 (September 27, 2011).
76 FR 56787 (September 14, 2011).
48
48
48
73

FR
FR
FR
FR

41104
41104
41105
40605

(September 13, 1983).
(September 13, 1983).
(September 13, 1983).
(July 15, 2008).

79 FR 24002 (April 29, 2014).

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Federal Register / Vol. 86, No. 170 / Tuesday, September 7, 2021 / Notices
10 INTERIOR/BIA–27, Bureau of Indian Affairs Probate Files .............
11 INTERIOR/BIA–34, National Irrigation Information Management
System (NIIMS).
12 INTERIOR/LLM–2, Range Management System .............................
13 INTERIOR/BLM–3, Mineral Lease Management .............................
14

INTERIOR/BLM–4, Coal Lease Data System ..................................

15

INTERIOR/BLM–6, Mineral Surveyor Appointment File ...................

16 INTERIOR/BLM–8, Aircraft Passenger Manifest Records—Fire
Control.
17 INTERIOR/BLM–10, Vehicle Use Authorization ...............................
18

INTERIOR/BLM–15, Correspondence Control .................................

19
20

INTERIOR/BLM–16, Timber Sale Information System (TSIS) .........
INTERIOR/BLM–18, Criminal Case Investigation ............................

21

INTERIOR/BLM–19, Civil Trespass Case Investigations .................

22

INTERIOR/BLM–20, Employee Conduct Investigations ...................

23

INTERIOR/BLM–28, Adopt a Wild Horse .........................................

24

INTERIOR/BLM–30, Uniform Accountability System .......................

25 INTERIOR/LLM–32, Land & Minerals Authorization Tracking System.
26 INTERIOR/LLM–37, Wild Horse & Burro Program System
(WHBPS).
27 INTERIOR/BLM–40, Incident Qualification and Certification System
(IQCS).
28 INTERIOR/BLM–42, General Land Office Records Automation
System (GLORAS).
29 INTERIOR/WBR–5, Claims ..............................................................
30

INTERIOR/WBR–7, Concessions .....................................................

31

INTERIOR/WBR–13, Irrigation Management Service ......................

32

INTERIOR/WBR–31, Acreage Limitation .........................................

33

INTERIOR/WBR–38, Water Right Applications ................................

34

INTERIOR/WBR–39, Water Rights Acquisition ................................

35

INTERIOR/WBR–40, Water Sales and Delivery Contracts ..............

36

INTERIOR/WBR–48, Lower Colorado River Well Inventory ............

37 INTERIOR/OS–09, Hearings and Appeals Files ..............................
38 INTERIOR/OS–30, Minerals Revenue Management Support System (MRMSS).
39 INTERIOR/OIG–1, Management Information ...................................
40 INTERIOR/OIG–2, Investigative Records .........................................
41 INTERIOR/OS–10, Electronic Email Archive System (EEAS) .........
42 INTERIOR/OS–12, Official Pilot Folders ..........................................
43 INTERIOR/OS–13, Aircraft Administrative Management and Fiscal
Records.
44 INTERIOR/OS–14, Take Pride In America System .........................

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45

INTERIOR/OS–20, Secretarial Controlled Correspondence File .....

46 INTERIOR/OS–21, Office of Insular Affairs Programs .....................
47 INTERIOR/OS–25, Youth Conservation Corps (YCC) Enrollee
Records.
48 INTERIOR/OS–26, Youth Conservation Corps (YCC), Enrollee
Payroll Recorder File.
49 INTERIOR/OS–27, Youth Conservation Corps (YCC) Enrollee
Medical Records.
50 INTERIOR/OS–29, Youth Conservation Corps (YCC) Recruitment
Files.
51 INTERIOR/OS–35, Library Circulation Control System ...................

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72 FR 8767 (February 27, 2007).
78 FR 7804 (February 4, 2013).
75 FR 82061 (December 29, 2010).
47 FR 55317 (December 8, 1982); modification published 73 FR 17376
(April 1, 2008).
47 FR 55317 (December 8, 1982); modification published 73 FR 17376
(April 1, 2008).
51 FR 25107 (Jul 10, 1986); modification published 73 FR 17376 (April
1, 2008).
42 FR 19112 (April 11, 1977); modification published 73 FR 17376
(April 1, 2008).
42 FR 19113 (April 11, 1977); modification published 73 FR 17376
(April 1, 2008).
42 FR 19114 (April 11, 1977); modification published 73 FR 17376
(April 1, 2008).
75 FR 3919 (January 25, 2010).
47 FR 55322 (December 8, 1982); modification published 73 FR 17376
(April 1, 2008).
47 FR 55322 (December 8, 1982); modification published 73 FR 17376
(April 1, 2008).
42 FR 19116 (April 11, 1977); modification published 73 FR 17376
(April 1, 2008).
51 FR 25111 (July 10, 1977); modification published 73 FR 17376
(April 1, 2008).
52 FR 36635 (September 30, 1987); modification published 73 FR
17376 (April 1, 2008).
56 FR 5014 (February 7, 1991); modification published 73 FR 17376
(April 1, 2008).
72 FR 67956 (December 3, 2007); modification published 73 FR 17376
(April 1, 2008).
73 FR 6996 (February 6, 2008).
79 FR 30158 (May 27, 2014).
64 FR 13234 (March 17, 1999); modification published 73 FR 20949
(April 17, 2008).
64 FR 69032 (December 9, 1999); modification 73 FR 20949 (April 17,
2008).
64 FR 29876 (June 3, 1999); modification published 73 FR 20949
(April 17, 2008).
64 FR 13235 (March 17, 1999); modification published 73 FR 20949
(April 17, 2008).
64 FR 29876 (June 3, 1999); modification published 73 FR 20949
(April 17, 2008).
64 FR 29876 (June 3, 1999); modification published 73 FR 20949
(April 17, 2008).
64 FR 29876 (June 3, 1999); modification published 73 FR 20949
(April 17, 2008).
64 FR 29874 (June 3, 1999); modification published 73 FR 20949
(April 17, 2008).
80 FR 26291 (May 7, 2015).
81 FR 16207 (March 25, 2016).
55 FR 14480 (April 18, 1990).
76 FR 60519 (September 29, 2011).
68 FR 4220 (January 28, 2003); modification published 73 FR 8342
(February 13, 2008).
74 FR 49004 (September 25, 2009).
74 FR 49002 (September 25, 2009).
68 FR 39958 (July 3, 2003); modification published 73 FR 8342 (February 13, 2008).
64 FR 20013 (April 23, 1999); modification published 73 FR 8342
(February 13, 2008).
78 FR 17705 (March 22, 2013).
56 FR 41700 (August 22, 1991).
56 FR 41700 (August 22, 1991).
56 FR 41700 (August 22, 1991).
51 FR 36862 (October 16, 1986).
64 FR 16988 (April 7, 1999); modification published 73 FR 8342 (February 13, 2008).

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50158

Federal Register / Vol. 86, No. 170 / Tuesday, September 7, 2021 / Notices

52

INTERIOR/OS–46, Secretarial Subject Files ...................................

53

INTERIOR/OS–47, Parking Assignment Records ............................

54

INTERIOR/OS–51, Property Accountability and Control System ....

55
56

INTERIOR/OS–69, Freedom of Information Appeals Files ..............
INTERIOR/OS–84, Delinquent Debtor File ......................................

57

INTERIOR/DOI–01, Interior Child Care Subsidy Program Records

58 INTERIOR/DOI–02, Interior Relocation Assistance Program
Records.
59 INTERIOR/DOI–04, Employee Assistance Program Records .........
60 INTERIOR/DOI–05, Interior Volunteer Services File System ..........
61 INTERIOR/DOI–06, America the Beautiful—The National Parks
and Federal Recreational Lands Pass System.
62 INTERIOR/DOI–07, Federal and Non-Federal Aviation Personnel,
Equipment, and Mishap Information Systems.
63 INTERIOR/DOI–08, DOI Social Networks ........................................
64 INTERIOR/DOI–10, Incident Management, Analysis and Reporting
System.
65 INTERIOR/DOI–11, Debarment and Suspension Program .............
66 INTERIOR/DOI–18, Civil Rights Complaints and Compliance Review Files.
67 INTERIOR/DOI–24, Indian Arts and Crafts Board ...........................
68 INTERIOR/DOI–36, Telephone Call Detail Records ........................
69 INTERIOR/DOI–45, HSPD–12: Identity Management System and
Personnel Security Files.
70 INTERIOR/DOI–47, HSPD–12: Logical Security Files (Enterprise
Access Control Service/EACS).
71 INTERIOR/DOI–52, Passport and Visa Records .............................
72
73

INTERIOR/DOI–57, Privacy Act Files ..............................................
INTERIOR/DOI–58, Employee Administrative Records ...................

74 INTERIOR/DOI–60, Safety Management Information System .........
75 INTERIOR/DOI–71, Electronic FOIA Tracking System and FOIA
Case Files.
76 INTERIOR/DOI–72, FECA Chargeback Case Files .........................
77

INTERIOR/DOI–74, Grievance Records ..........................................

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78 INTERIOR/DOI–76, Employee Training and Career Development
Records.
79 INTERIOR/DOI–77, Unfair Labor Practice Charges/Complaints
Files.
80 INTERIOR/DOI–78, Negotiated Grievance Procedure Files ............
81

INTERIOR/DOI–82, Executive Development Programs Files ..........

82
83
84
85
86
87

INTERIOR/DOI–86, Accounts Receivable: FBMS ...........................
INTERIOR/DOI–87, Acquisition of Goods and Services: FBMS ......
INTERIOR/DOI–88, Travel Management: FBMS .............................
INTERIOR/DOI–89, Grants and Cooperative Agreements: FBMS ..
INTERIOR/DOI–91, Oracle Federal Financials (OFF) .....................
INTERIOR/NPS–6, Audiovisual Performance Selection Files .........

88

INTERIOR/NPS–7, National Park Service Historical Library ...........

89

INTERIOR/NPS–8, Property and Supplies Accountability ...............

90

INTERIOR/NPS–10, Central Files ....................................................

91

INTERIOR/NPS–12, U.S. Park Police Personnel Photograph File ..

92

INTERIOR/NPS–13, Concessioners .................................................

93 INTERIOR/NPS–14, Concessioner Financial Statement and Audit
Report Files.
94 INTERIOR/NPS–15, Concessions Management Files .....................
95

INTERIOR/NPS–21, Visitor Statistical Survey Forms ......................

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64 FR 16983 (April 7, 1999); modification published 73 FR 8342 (February 13, 2008).
64 FR 16984 (April 7, 1999); modification published 73 FR 8342 (February 13, 2008).
64 FR 17404 (April 9, 1999); modification published 73 FR 8342 (February 13, 2008).
64 FR 16986 (April 7, 1999).
64 FR 18436 (April 14, 1999); modification published 73 FR 8342
(February 13, 2008).
66 FR 10309 (February 14, 2001); modification published 73 FR 8342
(February 13, 2008).
73 FR 55125 (September 24, 2008).
64 FR 20011 (April 23, 1999); modification published 73 FR 8342
(February 13, 2008).
66 FR 28536 (May 23, 2001).
80 FR 63246 (October 19, 2015).
74 FR 48774 (September 24, 2009).
76 FR 44033 (July 22, 2011).
79 FR 31974 (June 3, 2014).
76 FR 52341 (August 22, 2011).
73 FR 19088 (April 8, 2008).
80 FR 27700 (May 14, 2015).
59 FR 7260 (February 15, 1994); modification published 73 FR 8342
(February 13, 2008).
72 FR 11036 (March 12, 2007).
72 FR 11040 (March 12, 2007).
64 FR 16981 (April 7, 1999); modification published 73 FR 8342 (February 13, 2008) and 74 FR 34588 (July 16, 2009).
81 FR 45527 (July 14, 2016).
64 FR 19384 (April 20, 1999); modification published 73 FR 8342
(February 13, 2008).
81 FR 73135 (October 24, 2016).
81 FR 33544 (May 26, 2016).
64 FR 19380 (April 20, 1999); modification published 73 FR 8342
(February 13, 2008).
64 FR 19381 (April 20, 1999); modification published 73 FR 8342
(February 13, 2008).
64 FR 26999 (May 18, 1999); modification published 73 FR 8342 (February 13, 2008).
64 FR 18434 (April 14, 1999); modification published 73 FR 8342
(February 13, 2008).
64 FR 19383 (April 20, 1999); modification published 73 FR 8342
(February 13, 2008).
64 FR 20014 (April 23, 1999); modification published 73 FR 8342
(February 13, 2008).
73 FR 43772 (July 28, 2008).
73 FR 43766 (July 28, 2008).
73 FR 43769 (July 28, 2008).
73 FR 43755 (July 28, 2008).
80 FR 66551 (October 29, 2015).
42 FR 19073 (April 11, 1977), modification published 73 FR 63992
(October 28, 2008).
48 FR 51699 (November 10, 1983), modification published 73 FR
63992 (October 28, 2008).
48 FR 51700 (November 10, 1983), modification published 73 FR
63992 (October 28, 2008).
42 FR 19075 (April 11, 1977), modification published 73 FR 63992
(October 28, 2008).
64 FR 66196 (November 24, 1999), modification published 73 FR
63992 (October 28, 2008).
48 FR 51700 (November 10, 1983), modification published 73 FR
63992 (October 28, 2008).
48 FR 51701 (November 10, 1983), modification published 73 FR
63992 (October 28, 2008).
48 FR 51701 (November 10, 1983), modification published 73 FR
63992 (October 28, 2008).
48 FR 51705 (November 10, 1983), modification published 73 FR
63992 (October 28, 2008).

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Federal Register / Vol. 86, No. 170 / Tuesday, September 7, 2021 / Notices
96

INTERIOR/NPS–22, Motor Vehicle Operations Program ................

97 INTERIOR/NPS–23, Planning, Environment and Public Comment
(PEPC) System.
98 INTERIOR/NPS–24, Commercial Use Authorization (CUA) System
99 INTERIOR/OSM–8, Employment and Financial Interest Statements—States and Other Federal Agencies.
100 INTERIOR/OSM–12, Blaster Certification ......................................
101
102
103
104
105

INTERIOR/SOL–1,
INTERIOR/SOL–2,
INTERIOR/SOL–3,
INTERIOR/SOL–4,
INTERIOR/SOL–5,

Litigation, Appeal and Case Files ...................
Claims Files .....................................................
Patent Files .....................................................
Workload Analysis ...........................................
SMCRA Litigation Tracking System (LTS) ......

ROUTINE USES OF RECORDS MAINTAINED IN THE
SYSTEM, INCLUDING CATEGORIES OF USERS AND
THE PURPOSES OF SUCH USES:

To another Federal agency or Federal
entity, when DOI determines that
information from this system of records
is reasonably necessary to assist the
recipient agency or entity in (1)
responding to a suspected or confirmed
breach; or (2) preventing, minimizing, or
remedying the risk of harm to
individuals, the recipient agency or
entity (including its information
systems, programs, and operations), the
Federal Government, or national
security, resulting from a suspected or
confirmed breach.
Teri Barnett,
Departmental Privacy Officer, Department of
the Interior.
[FR Doc. 2021–19171 Filed 9–3–21; 8:45 am]
BILLING CODE 4334–63–P

DEPARTMENT OF THE INTERIOR
Bureau of Land Management
[L14400000 PN0000 HQ350000 212; OMB
Control No. 1004–0004]

Agency Information Collection
Activities; Desert Land Entry
Application
Bureau of Land Management,
Interior.
ACTION: Notice of information collection;
request for comment.
AGENCY:

In accordance with the
Paperwork Reduction Act of 1995
(PRA), the Bureau of Land Management
(BLM) proposes to renew an information
collection.
DATES: Interested persons are invited to
submit comments on or before October
7, 2021.
ADDRESSES: Written comments and
recommendations for this information
collection request (ICR) should be sent
within 30 days of publication of this
notice to www.reginfo.gov/public/do/
PRAMain. Find this particular

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SUMMARY:

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48 FR 51705 (November 10, 1983), modification published 73 FR
63992 (October 28, 2008).
79 FR 30641 (May 28, 2014).
78 FR 20944 (April 8, 2013).
64 FR 17412 (April 9, 1999); modification published 73 FR 45244 (August 4, 2008).
64 FR 17413 ( April 9, 1999); modification published 73 FR 45244 (August 4, 2008).
46 FR 12146 (February 12, 1981).
46 FR 12146 (February 12, 1981).
42 FR 18968 (April 11, 1977).
46 FR 12146 (February 12, 1981).
54 FR 7485 (February 21, 1989).

information collection by selecting
‘‘Currently under 30-day Review—Open
for Public Comments’’ or by using the
search function.
To
request additional information about
this ICR, contact Susie Greenhalgh by
email at [email protected], or by
telephone at 202–302–4288. Individuals
who are hearing or speech impaired
may call the Federal Relay Service at 1–
800–877–8339 for TTY assistance. The
ICR may also be viewed at http://
www.reginfo.gov/public/do/PRAMain.

FOR FURTHER INFORMATION CONTACT:

In
accordance with the PRA (44 U.S.C.
3501 et seq.) and 5 CFR 1320.8(d)(1), we
invite the public and other Federal
agencies to comment on new, proposed,
revised and continuing collections of
information. This helps the BLM assess
impacts of its information collection
requirements and minimize the public’s
reporting burden. It also helps the
public understand BLM information
collection requirements and ensure
requested data are provided in the
desired format.
A Federal Register notice with a 60day public comment period soliciting
comments on this collection of
information was published on April 20,
2021 (86 FR 20517). No comments were
received.
As part of our continuing effort to
reduce paperwork and respondent
burdens, we are again inviting the
public and other Federal agencies to
comment on the proposed ICR described
below. The BLM is especially interested
in public comment addressing the
following:
(1) Whether or not the collection of
information is necessary for the proper
performance of the functions of the
agency, including whether or not the
information will have practical utility.
(2) The accuracy of our estimate of the
burden for this collection of
information, including the validity of
the methodology and assumptions used.

SUPPLEMENTARY INFORMATION:

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(3) Ways to enhance the quality,
utility, and clarity of the information to
be collected; and
(4) How might the agency minimize
the burden of the collection of
information on those who are to
respond, including the use of
appropriate automated, electronic,
mechanical, or other technological
collection techniques or other forms of
information technology, e.g., permitting
electronic submission of response.
Comments submitted in response to
this notice are a matter of public record.
Before including your address, phone
number, email address, or other
personal identifying information in your
comment, you should be aware that
your entire comment—including your
personal identifying information—may
be made publicly available at any time.
While you can ask us in your comment
to withhold your personal identifying
information from public review, we
cannot guarantee that we will be able to
do so.
Abstract: The BLM uses the
information to determine if an
individual is eligible to make a desert
land entry for agricultural purposes.
OMB control number 1004–0004 is
scheduled to expire September 30, 2021.
The BLM is requesting that OMB renew
this OMB control number for an
additional three years.
Title of Collection: Desert Land Entry
Application (43 CFR part 2520).
OMB Control Number: 1004–0004.
Form Number: 2520–1.
Type of Review: Extension of a
currently approved collection.
Respondents/Affected Public:
Individuals who wish to make a desert
land entry for agricultural purposes.
Total Estimated Number of Annual
Respondents: 3.
Total Estimated Number of Annual
Responses: 3.
Estimated Completion Time per
Response: 2 hours.
Total Estimated Number of Annual
Burden Hours: 6.
Respondent’s Obligation: Required to
obtain or retain a benefit.

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