96-25058. Agency Forms Submitted for OMB Review

[Federal Register Volume 61, Number 191 (Tuesday, October 1, 1996)]
[Notices]
[Pages 51311-51312]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 96-25058]


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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: Application for Survivor Death Benefits.
    (2) Form(s) submitted: AA-21, AA-11a, G-131, and G-273a.
    (3) OMB Number: 3220-0031.
    (4) Expiration date of current OMB clearance: October 31, 1996.
    (5) Type of request: Revision of a currently approved collection.
    (6) Respondents: Individuals or households, Business or other for-
profit.
    (7) Estimated annual number of respondents: 22,600.
    (8) Total annual responses: 22,600.
    (9) Total annual reporting hours: 8,717.
    (10) Collection description: Collection obtains the information 
needed to pay

[[Page 51312]]

death benefits and annuities due but unpaid at death under the Railroad 
Retirement Act. Benefits are paid to designated beneficiaries or to 
survivors in a priority designated by law.

Additional Information or Comments

    Copies of the form and supporting documents can be obtained from 
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 DC 20503.
Chuck Mierzwa,
Clearance Officer.
[FR Doc. 96-25058 Filed 9-30-96; 8:45 am]
BILLING CODE 7905-01-M