99-26173. Agency Forms Submitted for OMB Review

[Federal Register Volume 64, Number 194 (Thursday, October 7, 1999)]
[Notices]
[Page 54696]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 99-26173]



[[Page 54696]]

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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 (RRB) 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 of Authority to Act for Employee.
    (2) Form(s) submitted: SI-10.
    (3) OMB Number: 3220-0034.
    (4) Expiration date of current OMB clearance: 12/31/1999.
    (5) Type of request: Extension of currently approved collection.
    (6) Respondents: Individuals or Households, Business or other for-
profit.
    (7) Estimated annual number of respondents: 400.
    (8) Total annual responses: 400.
    (9) Total annual reporting hours: 40.
    (10) Collection description: Under 20 CFR 335.2, the Railroad 
Retirement Board (RRB) accepts claims for sickness benefits by other 
than the sick or injured employees, provided the RRB has the 
information needed to satisfy itself that the delegation should be 
made.

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, 
Laurie Schack (202-395-7316), Office of Management and Budget, Room 
10230, New Executive Office Building, Washington, D.C. 20503.
Chuck Mierzwa,
Clearance Officer.
[FR Doc. 99-26173 Filed 10-6-99; 8:45 am]
BILLING CODE 7905-01-M