[Federal Register Volume 59, Number 114 (Wednesday, June 15, 1994)]
[Unknown Section]
[Page 0]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 94-14389]
[[Page Unknown]]
[Federal Register: June 15, 1994]
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OFFICE OF PERSONNEL MANAGEMENT
Request for Clearance of a Revised Information Collection Form RI
30-10
AGENCY: Office of Personnel Management.
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
clearance of a revised information collection. Form RI 30-10, Disabled
Dependent Questionnaire, is used to collect sufficient information
about the medical condition and earning capacity for OPM to be able to
determine whether a disabled adult child is eligible for health
benefits coverage and/or survivor annuity payments under the Civil
Service Retirement System/Federal Employees Retirement System.
Approximately 2,500 RI 30-10 forms are completed annually. The form
requires approximately 30 minutes to complete. The annual burden is
1,250 hours.
For copies of this proposal, contact C. Ronald Trueworthy on (703)
908-8550.
DATES: Comments on this proposal should be received on or before July
15, 1994.
ADDRESSES: Send or deliver comments to--
Lorraine E. Dettman, Chief, Retirement and Insurance Group, 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 3002, Washington, DC 20503.
FOR INFORMATION REGARDING ADMINISTRATIVE COORDINATION--CONTACT:
Mary Beth Smith-Toomey, Chief, Forms Analysis & Design, (202) 606-0623.
U.S. Office of Personnel Management.
Lorraine A. Green,
Deputy Director.
[FR Doc. 94-14389 Filed 6-14-94; 8:45 am]
BILLING CODE 6325-01-M
