Extension without change of a currently approved collection
No
Regular
07/31/2024
Requested
Previously Approved
36 Months From Approved
10/31/2024
350
200
88
50
230
80
The CM-910 is used to obtain
information about prospective representative payees to determine
whether they are qualified to handle monetary benefits on behalf of
a beneficiary under Part 901 of the Black Lung Benefits
Act.
US Code:
30
USC 901 Name of Law: Black Lung Benefits Act
EXPLANATION OF CHANGE TOTALS
Respondents: The number of respondents increased from 200 to 350.
The number of respondents increase due to a increase of requests to
be selected as Payee. The following also increased due to an
increased in number of forms received/responses. Responses:
Responses have increased from 200 to 350. Burden Hours: Burden
hours have increased from 50 to 87. The following Increased due to
program changes in mailing cost. Costs: Annual burden costs have
increased from $80.00 to $230.00.
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.