96-141. Agency Forms Submitted for OMB Review

[Federal Register Volume 61, Number 4 (Friday, January 5, 1996)]
[Notices]
[Page 423]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 96-141]



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RAILROAD RETIREMENT BOARD


Agency Forms Submitted for OMB Review

    Summary: In accordance with the Paperwork Reduction Act of 1995 (44 
U.S.C. Chapter 35), the Railroad Retirement Board has submitted the 
following proposal(s) for the collection of information to the Office 
of Management and Budget for review and approval.
    Summary of Proposal(s):
    (1) Collection title: Statement Regarding Contributions and 
Support.
    (2) Form(s) submitted: G-134.
    (3) OMB Number: 3220-0099.
    (4) Expiration date of current OMB clearance: November 30, 1995.
    (5) Type of request: Extension of a currently approved collection.
    (6) Respondents: Individuals or households.
    (7) Estimated annual number of respondents: 300.
    (8) Total annual responses: 300.
    (9) Total annual reporting hours: 92.
    (10) Collection description: Dependency on the employee for one-
half support at the time of the employee's death can be a condition 
affecting eligibility for a survivor annuity provided for under Section 
2 of the Railroad Retirement Act. One-half support is also a condition 
which may negate the public service pension offset in Tier I for a 
spouse or widow(er).
    Additional Information or Comments: Copies of the form and 
supporting documents can be obtained for Chuck Mierzwa, the agency 
clearance officer (312-751-3363). Comments regarding the information 
collection should be addressed to Ronald J. Hodapp, Railroad Retirement 
Board, 844 North Rush Street, Chicago, Illinois 60611-2092 and the OMB 
reviewer, Laura Oliven (202-395-7316), Office of Management and Budget, 
Room 10230, New Executive Office Building, Washington, D.C. 20503.
Ron Hodapp,
Acting Clearance Officer.
FR Doc. 96-141 Filed 1-4-96; 8:45 am]
BILLING CODE 7905-01-M