97-6294. Agency Forms Submitted for OMB Review

[Federal Register Volume 62, Number 49 (Thursday, March 13, 1997)]
[Notices]
[Page 11939]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 97-6294]


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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 and Claim for RUIA Benefits Due 
at Death.
    (2) Form(s) submitted: UI-63.
    (3) OMB Number: 3220-0055.
    (4) Expiration date of current OMB clearance: 4/30/97.
    (5) Type of request: Extension of a currently approved collection.
    (6) Respondents: Individuals or households.
    (7) Estimated annual number of respondents: 200.
    (8) Total annual responses: 200.
    (9) Total annual reporting hours: 23.
    (10) Collection description: The collection obtains the information 
needed by the Railroad Retirement Board to pay, under section 2(g) of 
the Railroad Unemployment Insurance Act, benefits under that Act 
accrued, but not paid because of the death of the employee.
    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. 97-6294 Filed 3-12-97; 8:45 am]
BILLING CODE 7905-01-M