96-11380. Proposed Collection; Comment Request for Reclearance of Information CollectionSF 2809

[Federal Register Volume 61, Number 90 (Wednesday, May 8, 1996)]
[Notices]
[Page 20867]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 96-11380]



=======================================================================
-----------------------------------------------------------------------

OFFICE OF PERSONNEL MANAGEMENT


Proposed Collection; Comment Request for Reclearance of 
Information Collection--SF 2809

AGENCY: Office of Personnel Management.

ACTION: Notice.

-----------------------------------------------------------------------

SUMMARY: In accordance with the Paperwork Reduction Act of 1995 (Public 
Law 104-13, May 22, 1995), this notice announces that the Office of 
Personnel Management intends to submit to the Office of Management and 
Budget a request for reclearance of the following information 
collection. SF 2809, Health Benefits Registration Form, is used by 
annuitants under Federal retirement systems other than the Civil 
Service Retirement System and the Federal Employees Retirement System 
and by the former spouses of Federal employees and annuitants to 
register for enrollment in the Federal Employees Health Benefits 
Program. SF 2809 is also used by these persons to change enrollments 
within the FEHBP. SF 2809 is needed to verify entitlement and to effect 
premium withholdings
    Approximately 9,000 SF 2809 forms will be processed each year from 
former spouses and annuitants from other retirement systems. Each form 
takes approximately 45 minutes to complete. The annual estimated burden 
is 6,750 hours
    For copies of this proposal, contact Jim Farron on [phone], 
or E-mail to [e-mail]

DATES: Comments on this proposal should be received on or before July 
7, 1996.

ADDRESSES: Send or deliver comments to: Kenneth H. Glass, Chief, 
Insurance Operations Division, Retirement and Insurance Service, U.S. 
Office of Personnel Management, 1900 E Street, NW, Room 3415, 
Washington, DC 20415-0001.

FOR FURTHER INFORMATION REGARDING ADMINISTRATIVE COORDINATION CONTACT: 
Mary Beth Smith-Toomey, Management Services Division, [phone].

U.S. Office of Personnel Management.
Lorraine A. Green,
Deputy Director.
[FR Doc. 96-11380 Filed 5-7-96; 8:45 am]
BILLING CODE 6325-01-M