[Federal Register Volume 60, Number 103 (Tuesday, May 30, 1995)]
[Notices]
[Pages 28182-28183]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 95-13057]
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OFFICE OF PERSONNEL MANAGEMENT
Notice of Request for Reclearance of OPM Form 2809
AGENCY: Office of Personnel Management.
[[Page 28183]] ACTION: Notice.
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SUMMARY: In accordance with the Paperwork Reduction Act of 1980 (title
44, U.S. Code, chapter 35), this notice announces a request for a
reclearance of an information collection. OPM Form 2809, Health
Benefits Registration Form, is used by annuitants and former spouses to
elect, cancel, or change health benefits enrollment during periods
other than open season.
Approximately 34,800 OPM Form 2809's are completed annually. We
estimate that it takes 45 minutes to fill out the form. The annual
burden is 26,100 hours.
For copies of this proposal, contact Doris R. Benz on (703) 908-
8464.
DATES: Comments on this proposal should be received on or before June
29, 1995.
ADDRESSES: Send or deliver comments to--
Lorraine E. Dettman, Retirement and Insurance Service, Operations
Support Division, U.S. Office of Personnel Management, 1900 E. Street,
NW, Room 3349, Washington, DC 20415
and
Joseph Lackey, OPM Desk Officer, Office of Information and Regulatory
Affairs, Office of Management and Budget, New Executive Office
Building, NW, Room 10235, Washington, DC 20503.
FOR INFORMATION REGARDING ADMINISTRATIVE COORDINATION--CONTACT: Mary
Beth Smith-Toomey, Team Leader, Forms Analysis and Design (202) 606-
0623.
U.S. Office of Personnel Management.
Lorraine A. Green,
Deputy Director.
[FR Doc. 95-13057 Filed 5-26-95; 8:45 am]
BILLING CODE 6325-01-M
